L16: Renal Cell Carcinoma Flashcards
Where does renal cell carcinoma arise in the kidney
In the cortex of tubules
What are the 3 main type of renal cell carcinoma
Clear cell
Papillary
Chromophobe
Which type of renal cell carcinoma is the most common
Clear cell carcinoma
What is the diagnostic triad for renal cell carcinoma
Haematuria
Flank pain
Abdominal mass
What are the other symptoms of renal cell carcinoma
Weight loss
Anaemia
Fever
What can clear cell carcinoma be
Familial
Sporadic
Metastatic from another primary tumour
When clear cell carcinoma is familial what is it
Von hipped Lindau syndrome
What is Von hipped landua syndrome
Autosomal dominant condition that results in the germ line mutation of the VHL tumour suppressor gene and a second somatic mutation (two hit hypothesis)
What pathway is the normal VHL protein involved in
HIF pathway
Does Von hipped lindau syndrome result in other tumour formation
Yes such as CNS and retina
How does the VHL gene function in the HIF pathway
By degrading HIF alpha
When there is VHL mutation or hypoxia what happens to HIF alpha
Accumulates
What does accumulation of HIF alpha cause
Increased VEGF - increases angiogenesis
Increases PDGF - increases glucose transport
Increased TGF alpha- increases stimulation of growth
What genetic abnormalities cause sporadic renal cell carcinoma
Chromosome 3p deletion that involves the VHL Gene, this causes loss of VHL gene functions
What is the surgical treatment for renal cell carcinoma
Partial nephrectomy
Radical nephrectomy
