Renal cancer Flashcards
most common type of renal cancer
Renal cell carcinoma
RCC pathophysiology
- adenocarcinoma of the renal cortex
- Arise predom. from the PCT
LLBB
Met. sites of RCC
- Lungs
- Liver
- Brain
- Bones
RCC classic triad
- Haematuria
- Flank pain
- Palpable mass
Most common clinical presentation of RCC
Haematuria
+
WL
Lethargy
Clinical features of RCC met.
- Bone pain - mass compressing on spine
- Cough/haemoptysis - lung met.
- Headaches/vision changes/altered mental state - Brain met.
3 common subtypes of RCC
Clear cell (around 80%)
Papillary (around 15%)
Chromophobe (around 5%)
RCC risk factors
Smoking
Obesity
Hypertension
End-stage renal failure
Von Hippel-Lindau Disease
Tuberous sclerosis
CXR findings on RCC
Cannonball met
RCC staging system
TNM
RCC TNM staging
Stage 1: < 7cm and confined to the kidney
Stage 2: > 7cm but confined to the kidney
Stage 3: Local spread to nearby tissues or veins, but not beyond Gerota’s fascia
Stage 4: Spread beyond Gerota’s fascia, including metastasis
RCC paraneoplastic features
- Polycythaemia - rise in EPO
- Hypercalcaemia - rise in PTH
- HTN - rise in renin
susp. RCC Ix
- Urine dip
- Urine MCS
- BT - FBC, UEs, Ca, LFTs, CRP
Initial imaging Ix for susp. RCC
USS KUB
susp. RCC gold standadr imaging
CT AP w/ IV contrast
Partial nephrectomy indications
T1 lesions (< 4 cm)
Met RCC Mx
Nephrectomy + immunotherapy
Radical nephrectomy indication
T2 lesions (> 4 cm)
