Renal Cancer

Question 1

What treatment are renal cancers resistant to?

Answer 1

Chemotherapy
Radiotherapy

Question 2

How is metastatic disease managed?

Answer 2

Biological therapy

Question 3

Which cancers are managed with partia nephrectomy?

Answer 3

T1 tumours
Below 4cm

Question 4

Which cancers are managed with radical nerve to my?

Answer 4

T2 tumours
Above 4cm mass

Question 5

What are the types of renal tumours?

Answer 5

Renal carcinoma

Transitional cell carcinoma

Question 6

What is renal cell carcinoma?

Answer 6

Renal cell carcinoma (RCC) is an adenocarcinoma of the renal cortex that originates from proximal convoluted tubules. Macroscopically, these tumours are well circumscribed, with a yellowish appearance denoting their high fat and glycogen content.

Question 7

What is a transitional cell carcinoma?

Answer 7

Transitional cell carcinoma (TCC) of the renal pelvis is a carcinoma type that shares properties with TCC of the bladder and ureter. Macroscopically, these lesions can be papillary or flat (sessile), and microscopically, TCC shows areas of squamous differentiation, extensive keratinization and intracellular bridges.

Question 8

What are the risk factors for renal cel caricnoma?

Answer 8

European
North American ethnicity
Obesity
Smoking
Low vitamin diet
Hypertensions

Question 9

What are the paraneoplastic syndrome with renal carcinoma?

Answer 9

High EPO production causing ruddy complexion
PTHrp secretion causing hypercalcaemia
ACTH secretion causing Cushing’s disease

Question 10

What is the referral criteria for rneal carcinoma?

Answer 10

they are aged 45 years and over and have:
Unexplained visible haematuria without urinary tract infection, or
Visible haematuria that persists or recurs after successful treatment of urinary tract infection

Question 11

What imaging assesses for metastatic disease?

Answer 11

CT chest and abdomen

Question 12

When is chemotherapy offered?

Answer 12

Patients with Nicolette resection tor deuce recurrence chances

Palliative patients

Question 13

When is radiotherapy offered?

Answer 13

Palliative care

Question 14

What is the most common rena malignancy in children?

Answer 14

Wilm’s tumour between the ages of 2 and 5

Question 15

What cancer is associated with sickle cell trait?

Answer 15

Renal medullary carcinoma which predominately affect the right side of the

Question 16

What is the diagnostic imaging for renal cancer?

Answer 16

USS abdomen and renal tract to assess for renal pelvis too

Question 17

Which imaging assess lower urinary tract?

Answer 17

CT urogram and cystoscopy

Question 18

What is a risk in renal cancer in regard to surrounding structures?

Answer 18

Obstruction of IVC causing bilateral pedal oedema

Question 19

What is Stauffer syndrome?

Answer 19

a paraneoplastic disorder associated with renal cell cancer
typically presents as cholestasis/hepatosplenomegaly
it is thought to be secondary to increased levels of IL

Question 20

What is Von Hippel Laundau syndrome?

Answer 20

characterized by hemangioblastomas of the brain, spinal cord, and retina; renal cysts and clear cell renal cell carcinoma

Question 21

What reduces tumour size?

Answer 21

alpha-interferon and interleukin-2 have been used to reduce tumour size and also treat patients with metatases

Question 22

What is nephroblastoma commonly known as?

Answer 22

Wilm’s tumours

Nephroblastoma is a type of kidney cancer that primarily affects children.

Question 23

At what age does nephroblastoma usually present?

Answer 23

In the first 4 years of life

Most cases are diagnosed in children under 5 years old.

Question 24

What are common symptoms of nephroblastoma?

Answer 24

A mass associated with haematuria and pyrexia may occur in 50%

Haematuria refers to the presence of blood in urine.

Question 25

Where do nephroblastoma metastases typically occur?

Answer 25

Usually to the lung ## Footnote Early metastasis to the lungs is a common characteristic of nephroblastoma.

Question 26

What is the primary treatment for nephroblastoma?

Answer 26

Nephrectomy ## Footnote Nephrectomy is the surgical removal of the kidney.

Question 27

What is the prognosis for younger children with nephroblastoma?

Answer 27

Better prognosis, with <1 year of age having 80% overall 5 year survival ## Footnote Younger patients tend to respond more favorably to treatment.

Question 28

What is neuroblastoma?

Answer 28

Most common extracranial tumour of childhood 80% occur in those under 4 years of age Tumour of neural crest origin (up to 50% occur in the adrenal gland) The tumour is usually calcified and may be diagnosed using MIBG scanning

Question 29

What is angiomyolipoma?

Answer 29

80% of these hamartoma type lesions occur sporadically, the remainder are seen in those with tuberous sclerosis Tumour is composed of blood vessels, smooth muscle and fat Massive bleeding may occur in 10% of cases