Penile and Renal tumours

Question 1

Whta are the benign renal tumours?

Answer 1

renal cysts; oncocytoma; angiomyolipoma

Question 2

What tumour is found in the renal pelvis?

Answer 2

TCC

Question 3

What is the tumour of renal parenchyma?

Answer 3

RCC

Question 4

What is the embryonic renal tumour?

Answer 4

nephroblastoma- Wilm’s tumour

Question 5

What is a CT used for in renal tumours?

Answer 5

staging

Question 6

What is an MRI used for in renal tumours?

Answer 6

to determine whether it is a tmour or a haemorrhage

Question 7

How are renal cysts diagnosed?

Answer 7

usually incidentally on USS

Question 8

What does hamartoma mean?

Answer 8

normal components of kidney tissue but abnomrla compositions- growing in an abnormal manner

Question 9

What disease is angiomyolipoma associated with?

Answer 9

tuberous sclerosis

Question 10

What is a complication of angiomyolipoma?

Answer 10

haemorrhage- wunderlichs syndrome

Question 11

What is wunderlichs syndrome?

Answer 11

spontaneous non-traumatic renal haemorrhage

Question 12

When is there an increased risk of haemorrhage with angiomyolipoma?

Answer 12

when the tumour is greater than 6cm

Question 13

What is considered the hallmark of AML on CT?

Answer 13

negative Hounsfield units- which indicate adipose tissue (<10)

Question 14

How do oncocytomas appear on CT?

Answer 14

central scar

Question 15

What is the difficulty with diagnosis of oncocytoma?

Answer 15

no definitive diagnosis except at nephrectomy

Question 16

What is the classical triad of RCC?

Answer 16

loin pain; renal mass; haematuria

Question 17

What are the paraneoplastic syndromes seen with RCC?

Answer 17

weight loss, anaemia, HT (renin) and hypercalcaemia (PTH); polycythaemia (erythropoeitin)

Question 18

Who gets RCC?

Answer 18

males 2:1; 65-75 year olds

Question 19

What are the type of cancer is RCC?

Answer 19

adenocarcinoma of the proximal convoluted tubule

Question 20

what are the variants of RCC?

Answer 20

clear cell; papillary

Question 21

What is von hippel-lindau syndrome?

Answer 21

autosomal dominant muation of a tumour suppressor gene

Question 22

What are the tumours seen with von hippel-lindau?

Answer 22

bilateral renal cysts- which can transform to RCC; retinal and cerebellar haemangioblastoma; phaeochomocytoma

Question 23

When should von hippel-lindau be susoected in a patient with RCC?

Answer 23

if they are bilateral and young

Question 24

What is the diagnosis of RCC?

Answer 24

triple phase contrast and renal biopsy

Question 25

Where does RCC tend to spread?

Answer 25

lungs; liver; bone; brain

Question 26

What is the treatment for RCC?

Answer 26

radical nephrectomy; partial nephrectomy; radiofrequency ablation; cryoablation

Question 27

What is the difference in surgical technique between radical and partial nephrectomy?

Answer 27

radical- laparoscopic whereas partial is open

Question 28

What is sunitinib?

Answer 28

VEGF/PDGF inhibitors- reduce neovascularization

Question 29

In addtion to sunitinib, what other treatments can be given?

Answer 29

IL2 and interferon alpha

Question 30

What are the premalignant cutaneous lesions with penile cancer?

Answer 30

balanitis xerotica obliterans; leukoplakia

Question 31

What areas of the penis does BXO affect?

Answer 31

prepuce; glans; urethral extension

Question 32

What are the signs of BXO?

Answer 32

white, patches, fissuring, bleeding and scarring

Question 33

What are the treatments for BXO?

Answer 33

circumcision; dilatation of meatus- due to stenosis; glans resurfacing

Question 34

What are the types of SCC in situ?

Answer 34

erythroplasia of Queyrat; Bowen's disease

Question 35

What is the difference between eryhtroplasia of Queyrat and bowens?

Answer 35

erythroplasia of Queyrat affects glans, prepuce or shaft of penis whereas Bowen's affects the remainder of the genitalia

Question 36

What is the treatment for SCC in situ if it just affects the prepuce?

Answer 36

circumcision

Question 37

What is the treatment for SCC in situ that affects areas aside from the prepuce?

Answer 37

topical 5 fluorouracil

Question 38

How does SCC of the penis present?

Answer 38

red raised area on the penis; fungating mass, foul smelling; phimosis

Question 39

How is SCC of penis diagnosed?

Answer 39

MRI

Question 40

When is the peak incidence of SCC of penis?

Answer 40

80 years

Question 41

What virus is associated with SCC of penis?

Answer 41

HPV type 16

Question 42

What is the rteatmnet for penile SCC?

Answer 42

total/partial penectomy and reconstruction; inguinal lymph nodes or sentinal biopsy

Question 43

What are hte types of non-seminomatous germ cell tumour?

Answer 43

teratoma; embryonal, yolk sac and choriocarcinoma

Question 44

What is the presentation of testicular tumours?

Answer 44

painless; insensitive testicular swellign; mets- neck nodes; dyspnoea

Question 45

What is the diagnosis of testicular tumours?

Answer 45

USS

Question 46

What imagin is done for staging of a testicular tumour?

Answer 46

CXR; CT abdo/thorax

Question 47

What does beta HCG indicate about the tumour?

Answer 47

trophoblastic tumour

Question 48

What does AFP indicate about the tumour?

Answer 48

not a pure seminoma

Question 49

What does LDH tell you about the tumour?

Answer 49

indicates tumour burden- if very increased, likely to have mets

Question 50

What is the treatment for testicular tumours?

Answer 50

orchidectomy

Question 51

What is significant about residual lymph nodes masses in testicular tumours?

Answer 51

1/3 harbour residual tumour