Renal Cancer

Question 1

Most common type ?

Answer 1

renal cell carcinoma (90%)

Question 2

RF?

Answer 2

smoking
FHx 
NSAIDs 
obesity 
Hep C

Question 3

Presentation?

what scrotal swelling is it associated with?

Answer 3

Most found incidentally. Haematuria, loin pain, abdominal mass, anorexia, malaise, weight loss

and rarely can cause a varicocele

Question 4

classically presents in triad of ?

Answer 4

haematuria
loin pain
loin mass

Question 5

Imaging – The best initial investigation is to perform a?

Answer 5

CT scan before and after IV contrast

Question 6

Tx

if tumour is less than 7 cm?

if greater?

Answer 6

do partial nephrectomy (just as good as radical) +chemo/radiotherapy

do radical nephrectomy +chemo/radiotherapy

Question 7

what do you see on cxr?

Answer 7

cannonnball mets in lung

Question 8

Ix?

Answer 8

Bloods -
ALP will be raised - bony mets
FBC - anaemia due to long standing haematuria

Question 9

prognostic score?

Answer 9

Mayo prognostic risk score (SSIGN),

stage, size, grade and necrosis.