Case 2 - renal cell carcinoma Flashcards
What might explain the apparent rise in renal cell carcinoma?
rise of US and CT scan
Where in the kidney is a renal cancer usually found?
cortex / medulla
90% from kidney parenchyma
Where else might a renal cancer be from?
bladder urothelium / transitional cell layers
Name 3 types of RCC in adults
clear cell carcinoma (75-80%)
Papillary
Chromophobe
What might a clear cell carcinoma look like?
emty space is white - cytoplasm has lots of glycogen and fat which is dissolved
Name 5 features of RCC
heamaturia Flank pain Abdominal mass DIagnostic triad in 9% of patients other manifestations (weight loss, anaemia...)
Which of familial or sporadic RCC is rarer?
familial
Name a type of familial RCC
Von HIppel Lindau syndrome
How is Von Hippel Lindau Syndrome inherited?
AD
germline mutation of VHL tumour suppressor gene, located on chromosome 3p - 2 hit model
What sorts of tumours might those with VHL syndrome present with?
epididymal cystadenomas Adrenal phaeochromocytoma Renal cysts and carcinoma Pancreatic cysts and cystadenomas brain, spinal cord, and retinal haemangioblastoma and cysts
What does normal VHL gene function lead to?
HIF- alpha degradation
What does VHL mutation or hypoxia lead to?
accumulation of HIF-alpha
resulting VEGF, PDGF, TGF-alpha formation
these create a stable environment for the tumour through angiogenesis, glucose transport, and autocrine growth stimulation
What might a clear cell carcinoma look like with your eye?
yellow because of the fat
What is the mean age of presentation of sporadic clear cell RCC?
61
What would you use to fix the tissue samples of RCC?
formalin
