Renal

Question 1

Pathological type of RCC

Answer 1

Rakib sir
Clear cell 75%
Non clear cell:
- papillary
- chromophobe
-oncocytic
- sarcomatoid( bad prognosis/ aggressive)
Other: ewings

Renal cell tumor
clear cell RCC (80-90%)-
papillary RCC (10-15%)-
Chromophobe RCC (4-5%)-
ca of the collecting ducts of bellini <1%-
Renal medullary ca -very aggressive-
oncocytoma
other -
tubulocycarcinoma-
papillary adenoma
predominant histologica type: adenocarcinoma

Question 2

other pathological types of RCC

Answer 2

B. Metanephric tumors-
metanephric adenoma-
metanephric
C. Mesenchymal tumors-
leiomyosarcoma-
angiosarcoma-
rhabdomyosarcoma-
osteosarcoma -
synovial sarcoma-
hemangioma
D. Mixed epithelial and stromal tumor
E. Germ cell tumor
F. Metastatic tumor

Question 3

Secondary renal tumors example

Answer 3

usually bilaterallung 20%,
breast 12%
stomach 11%ovary-
opposite kidney
NHL

Question 4

risk factors of RCC

Answer 4

Environmental
cadmium exposure-
asbestos,
petroleum-
analgesic-
phenacetin
occupational
leather worker-
shoe -
asbestos worker-
oil refinery
hormonal
diethystibestrol-
cytoxic CT in childhood
Renal:-
dialysis-
RCC-Renal transplant
other
obesity,
smoking,
HTN,
tuberous sclerosis

Question 5

genetic/familiar cause of RCC

Answer 5

Von hippel lindau disease
protein polybromo gene 1
papillary renal cell carcinoma

Question 6

paraneoplastic syndrome associated with renal cell carcinoma

Answer 6

hypercalcemia
polycythemia
polyneuropathy
amyloidosis

Question 7

hypercalcemia are common PNS in

Answer 7

sq cell carcinoma of lung
breast carcinoma
RCC
adult T cell leukemia
ovarian carcinoma

Question 8

common site of distant metastasis in RCC

Answer 8

bone, liver, lung , brain, soft tissue
lung 75% ??

Question 9

MSKCC prognostic factor for renal cell cancer

Answer 9

Interval from diagnosis to treatment of less than 1 year•
Karnofsky performance status less than 80%•
Serum LDH greater than 1.5 times the upper limit of normal (ULN) •
Corrected serum calcium greater than the ULN•
Serum hemoglobin less than the lower limit of normal (LLN)

Question 10

Common drug used

Answer 10

Preferred regimen for clear cell histology: if favorable histology
- Axitinib+ pembrolizumab
- Cabozantinib + nivolumab
- Lenvatinib + pembrolizumab
Other:
- axitinib + avelumab
- Cabozantinib
- Ipilimumab + nivolumab
- Pazopanib
- Sunitinib

Question 11

Prognosis depends on(rakib sir)

Answer 11

Albumin
ESR
Hb%
Alk phosphatase
Performance status
Calcium