Kidney - Cancer

Question 1

Renal cell cancer
-most common type
-associations and risk factors

Answer 1

Clear cell

Middle age men
Smoking
Von Hippel Lindau syndrome
Tuberous sclerosis
Slightly increased in ADPKD

Question 2

Renal cell cancer
-presentation

Answer 2

Triad of
-hematuria
-loin pain
-abdo mass

Pyrexia of unknown origin

Endocrine effects
-EPO secreting => polycythemia
-PTHrp => hypercalcemia
-renin => increased BP
-ACTH

Varicocele on LHS - tumour compresses testicular vein

Stauffer syndrome (paraneoplastic hepatic dysfunction)
-cholestasis, hepatosplenomegaly

Question 3

Renal cell cancer
-management

Answer 3

If confined - partial or total nephrectomy

Reduce size - a interferon, IL 2

Radiotherapy, chemotherapy usually not effective

Question 4

Renal cell cancer
-investigations

Answer 4

Renal tract US