Renal Cancer Flashcards
What are 2 types of benign renal cancer
Oncocytoma,
Angiomyolipoma
What is the most common cell type from malignant renal cancers
Renal adenocarcinoma
What are renal adenocarcinomas also called
Hypernephroma or Grawitz tumour
What part of the kindey do renal adenocarcinomas most often occur
Proximal tubules
Whats the histological subtypes of renal adenocarcinomas
clear cell (85%)
papillary (10%)
chromophobe (4%)
Bellini type ductal carcinoma (1%)
What are the risk factors for renal cancer
Family history (autosomal dominant e.g. vHL, familial clear cell RCC, hereditary papillary RCC; can be bilateral and/or multifocal)
Smoking
Anti-hypertensive medication
Obesity
End-stage renal failure
Acquired renal cystic disease
What the presenting symptoms for renal cancer
Asymptomatic (50%)
‘Classic triad’ of flank pain, mass and haematuria : 10%
Paraneoplastic syndrome : 30%
Metastatic disease : 30%
What are the symptoms of paraneoplastic syndrome in renal cancer
Anorexia, cachexia and pyrexia
Hypertension, hypercalcaemia and abnormal LFTs
Anaemia, polycythaemia and raised ESR
What are the investigations for renal cancer
CT scan
Bloods (u and e, FBC)
Ultrasound
What CT scans are mandatory is you suspect renal cancer
Abdomen and chest
Assess contralateral kidney
Why is ultrasound useful in investigating renal cancer
- Ultrasound differentiates tumour from cyst
What are the T1 staging criteria for renal cancer
Tumour < 7cm confined within renal capsule
What are the T2 staging criteria for renal cancer
Tumour >7cm & confined within capsule
What are the T3 a, b, c staging criteria for renal cancer
Local extension outside capsule
T3a - Into adrenal or peri-renal fat
T3b - Into renal vein or IVC below diaphragm
T3c - Tumour thrombus in IVC extends above diaphragm
What are the T4 staging criteria for renal cancer
Tumour invades beyond Gerota’s fascia
