GU Cancer: Kidney Cancer

Question 1

Renal cell carcinoma definition

Answer 1

Adenocarcinoma of the proximal convoluted tubule epithelium
MC type of kidney cancer in adults

Question 2

Epidemiology

Answer 2

60-70
Male
Black

Question 3

Risk factors

Answer 3

Smoking (MC)
Haemodyalisis
Hereditary
VON HIPPELINDAU = Auto dom = loss of TSG
- Px = RCC (50%) BILATERALLY + renal + pancreas cysts + cerebellum cancers
HTN

Question 4

Signs and Symptoms

Answer 4

Often asymptomatic
TRIAD:
- flank pain
- haematuria
- abdo mass
Constitutional symptoms:
- weight loss
- fatigue
- fever
Signs
Flank mass
May have left sided varicocele
May also have HTN
Anaemia
Mets: SOB, Chronic liver disease, bone pain

Question 5

Diagnosis

Answer 5

FIRST LINE = USS
GOLD STANDARD = CT chest/abdo/pelvis

Question 6

Staging

Answer 6

ROBSON STAGING 1-4

Question 7

Treatment

Answer 7

Nephrectomy (full/ partial if bilateral)
If met = IFN-a or biologics = sunitinib

Question 8

Wilms Tumour Definition

Answer 8

renal mesenchymal stem cell tumour SEEN IN CHILDREN (>3 years old), much rarer
aka nephroblastoma

Question 9

Endocrine associations

Answer 9

Erythropoietin → polycythaemia
Parathyroid hormone-related peptide (PTHrP) → hypercalcaemia
ACTH → Cushing’s syndrome
Renin