Penile and Renal tumours Flashcards
Whta are the benign renal tumours?
renal cysts; oncocytoma; angiomyolipoma
What tumour is found in the renal pelvis?
TCC
What is the tumour of renal parenchyma?
RCC
What is the embryonic renal tumour?
nephroblastoma- Wilm’s tumour
What is a CT used for in renal tumours?
staging
What is an MRI used for in renal tumours?
to determine whether it is a tmour or a haemorrhage
How are renal cysts diagnosed?
usually incidentally on USS
What does hamartoma mean?
normal components of kidney tissue but abnomrla compositions- growing in an abnormal manner
What disease is angiomyolipoma associated with?
tuberous sclerosis
What is a complication of angiomyolipoma?
haemorrhage- wunderlichs syndrome
What is wunderlichs syndrome?
spontaneous non-traumatic renal haemorrhage
When is there an increased risk of haemorrhage with angiomyolipoma?
when the tumour is greater than 6cm
What is considered the hallmark of AML on CT?
negative Hounsfield units- which indicate adipose tissue (<10)
How do oncocytomas appear on CT?
central scar
What is the difficulty with diagnosis of oncocytoma?
no definitive diagnosis except at nephrectomy
What is the classical triad of RCC?
loin pain; renal mass; haematuria
What are the paraneoplastic syndromes seen with RCC?
weight loss, anaemia, HT (renin) and hypercalcaemia (PTH); polycythaemia (erythropoeitin)
Who gets RCC?
males 2:1; 65-75 year olds
What are the type of cancer is RCC?
adenocarcinoma of the proximal convoluted tubule
what are the variants of RCC?
clear cell; papillary
What is von hippel-lindau syndrome?
autosomal dominant muation of a tumour suppressor gene
What are the tumours seen with von hippel-lindau?
bilateral renal cysts- which can transform to RCC; retinal and cerebellar haemangioblastoma; phaeochomocytoma
When should von hippel-lindau be susoected in a patient with RCC?
if they are bilateral and young
What is the diagnosis of RCC?
triple phase contrast and renal biopsy
Where does RCC tend to spread?
lungs; liver; bone; brain
What is the treatment for RCC?
radical nephrectomy; partial nephrectomy; radiofrequency ablation; cryoablation
What is the difference in surgical technique between radical and partial nephrectomy?
radical- laparoscopic whereas partial is open
What is sunitinib?
VEGF/PDGF inhibitors- reduce neovascularization
In addtion to sunitinib, what other treatments can be given?
IL2 and interferon alpha
What are the premalignant cutaneous lesions with penile cancer?
balanitis xerotica obliterans; leukoplakia
What areas of the penis does BXO affect?
prepuce; glans; urethral extension
What are the signs of BXO?
white, patches, fissuring, bleeding and scarring
What are the treatments for BXO?
circumcision; dilatation of meatus- due to stenosis; glans resurfacing
What are the types of SCC in situ?
erythroplasia of Queyrat; Bowen’s disease
What is the difference between eryhtroplasia of Queyrat and bowens?
erythroplasia of Queyrat affects glans, prepuce or shaft of penis whereas Bowen’s affects the remainder of the genitalia
What is the treatment for SCC in situ if it just affects the prepuce?
circumcision
What is the treatment for SCC in situ that affects areas aside from the prepuce?
topical 5 fluorouracil
How does SCC of the penis present?
red raised area on the penis; fungating mass, foul smelling; phimosis
How is SCC of penis diagnosed?
MRI
When is the peak incidence of SCC of penis?
80 years
What virus is associated with SCC of penis?
HPV type 16
What is the rteatmnet for penile SCC?
total/partial penectomy and reconstruction; inguinal lymph nodes or sentinal biopsy
What are hte types of non-seminomatous germ cell tumour?
teratoma; embryonal, yolk sac and choriocarcinoma
What is the presentation of testicular tumours?
painless; insensitive testicular swellign; mets- neck nodes; dyspnoea
What is the diagnosis of testicular tumours?
USS
What imagin is done for staging of a testicular tumour?
CXR; CT abdo/thorax
What does beta HCG indicate about the tumour?
trophoblastic tumour
What does AFP indicate about the tumour?
not a pure seminoma
What does LDH tell you about the tumour?
indicates tumour burden- if very increased, likely to have mets
What is the treatment for testicular tumours?
orchidectomy
What is significant about residual lymph nodes masses in testicular tumours?
1/3 harbour residual tumour
