Renal Cancer Flashcards
What is the most common type of renal cancer?
What are the 3 most common subtypes of this tumour?
Renal cell carcinoma
3 subtypes:
- clear cell= most common
- papillary
- chromophobe
What are the risk factors for developing RCC?
Smoking Obesity Hypertension ESRF Von Hippel-Lindau disease Tuberous sclerosis
How might someone with RCC present?
Haematuria
Vague loin pain
Non-specific symptoms of cancer
- weight loss
- fatigue
- anorexia
- night sweats
- palpable renal mass
Bone pain if mets
What is the classic sign of metastic RCC?
Why does this occur?
Cannonball mets in lungs i.e. well-defined circular opacities through lung fields
Due to cancer spreading to renal vein which then drains to IVC -> right side of heart and then to lungs
What paraneoplastic syndromes are associated with RCC?
Polycythemia
-unregulated secretion of EPO
Hypercalcaemia
- secretion of hormone which mimics actions of parathyroid hormone
- bony mets
Hypertension
- increased renin secretion
- physical compression of venous/arterial structures
- polycythaemia
Stauffer’s syndrome
-abnormal LFT w/o liver mets
What investigations can be done if RCC suspected?
Urinalysis + cytology
U+E
FBC-> might see anaemia secondary to haematuria or polycythaemia
CT TAP
What are the different T stages for RCC?
1= <7cm and confined to kidney 2= >7cm and confined to kidney 3= local spread to tissues or veins but not beyond Gerota’s fascia 4= spread beyond Gerota’s fascia + mets
What are the management options for RCC?
Surgery
- Partial nephrectomy
- Radical nephrectomy
When not suitable for surgery:
-arterial embolisation i.e. cutting off blood supply to affected kidney
- percutaneous cryotherapy i.e. injecting liquid nitrogen into kidney to kill cancer cells
- radiofrequency ablation i.e. needle in tumour and electrical current used to kill tumour cells
- chemo in advance disease
What is Wilms’ tumour?
Specific type of tumour which affects children (esp <5yo)
Most common type of RCC in children
