Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2MBChB Renal > Renal Cancer > Flashcards

Renal Cancer Flashcards

1
Q

What are the main types of benign renal cancer?

A

Simple cysts.

Angiomyolipoma.

Oncocytoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main types of malignant renal cancer?

A

Renal cell carcinoma (sold/complex cystic).

Transitional cell carcinoma.

Lymphoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the appearance of an oncocytoma?

A

Spherical.

Capsulated.

Brown/tan colour.

Central scar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is seen histologically in an oncocytoma?

A

Aggregates of eosinophilic cells.

Mitosis is rare.

Cells are packed with mitochondria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does a spoke wheel pattern on CT suggest?

A

Oncocytoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the treatment for an oncocytoma?

A

Small tumours less than 3 cm: surveillance in elderly unfit patients; ablation techniques in fit elderly patients and elected younger patients.

More than 3cm: partial nephrectomy; radical nephrectomy.

Large tumours: radical nephrectomy; laparoscopic approach gold standard.

Same as a renal cell carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the associated between angiolipoma and tuberous sclerosis?

A

80% of patients with tuberous sclerosis develop angiolipoma.

This makes up for 20% of all angiolipoma cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the investigations used to diagnose angiolipoma?

A

USS (bright echo pattern).

CT (fatty tumour of low density).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Wunderlich’s syndrome?

A

Massive retroperitoneal renal haemorrhage that occurs in 10% of angiolipomas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment for an angiolipoma?

A

4cm is the cutoff for treatment.

Elective: embolisation or partial nephrectomy.

Emergency: embolisation or emergency nephrectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a renal cell carcinoma?

A

Adenocarcinoma of the renal cortex.

Believed to arise from the proximal convoluted tubule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the gross appearance of a renal cell carcinoma?

A

Tan coloured.

Lobulated.

Solid.

10-25% either contain cysts or are predominantly cysts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are renal cell carcinomas classified histologically?

A

Conventional clear cell carcinoma (80%) - loss of Von Hippel Landau (VHL) gene on short of chromosome 3.

Papillary (10-15%): 40% are multifocal.

Chromophobe (5%).

Collecting duct: rare, young patients, poor prognosis.

Medullary cell: young sickle cell patients, very poor prognosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the risk factors for renal cell carcinoma?

A

Smoking.

Renal failure and dialysis.

Obesity.

Hypertension.

Low socio-economic status, asbestos, cadmium exposure, phenacetin.

Genetic: Von Hippel Landau (VHL) syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Von Hippel Landau (VHL) syndrome?

A

Autosomal dominant syndrome.

50% of cases develop renal cell carcinoma.

Loss of both copies of a tumour suppressor gene at chromosome 3p25.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does renal cell carcinoma commonly present?

A

Haematuria, loin pain, mass.

Pyrexia of unknown origin (8-9 %)

Varicocoele.

Paraneoplastic syndrome (30%).

17
Q

What investigations aid diagnosis of renal cell carcinoma?

A

USS.

CT chest, abdomen and pelvis (staging).

Bloods: FBC, renal and liver functions.

18
Q

What is the treatment for renal cell carcinoma?

A

Small tumours less than 3 cm: surveillance in elderly unfit patients; ablation techniques in fit elderly patients and elected younger patients.

More than 3cm: partial nephrectomy; radical nephrectomy.

Large tumours: radical nephrectomy; laparoscopic approach gold standard.

Same as oncocytoma.

19
Q

How long do you follow up patients who have had a renal cell carcinoma?

A

5-10 years.

In the follow up do FBC, renal and liver function and imaging (CT/USS + CXR).

20
Q

What is cryptorchidism?

A

A condition in which one or both of the testes fail to descend from the abdomen into the scrotum.

21
Q

What does cryptorchidism put you at risk of?

A

5-10% of testicular cancer patients have a history of cryptorchidism.

  • Orchidopexy (surgery to move a testicle that has not descended or moved down to its proper place in the scrotum​) before 13 years of age: 2 fold increase in risk.*
  • Orchidopexy after 13 years of age: 5 fold increase in risk.*
22
Q

What are the risk factors for testicular cancer?

A

HIV.

Family history.

Cryptorchidism.

Previous testicular cancer.

23
Q

What are the histopathological types of testicular cancer?

A

90% originate from germ cells.

24
Q

What is the common clinical presentation of testicular cancer?

A

Scrotal lump.

Delayed presentation occasionally seen.

5% have acute pain due to bleeding.

10% have symptoms of advanced disease including weight loss, neck lumps, chest symptoms or bone pain.

25
Q

On examination, what suggests someone has testicular cancer?

A

Asymmetry or slight scrotal discolouration.

Examine the normal side first.

Hard, non-tender, irregular mass mostly intratesticular.

Assess involvement of epididymis, spermatic cord and scrotal skin.

Secondary hydrocoele.

Abdominal mass – advanced disease.

26
Q

What investigations are carried out to diagnose a testicular cancer?

A

USS of the testicle.

CT chest and abdomen for staging.

Bloods: serum tumour markers (alpha-fetoprotein, B-HCG, LDH) - raised in 50% of cases; FBC, LFTs, RFTs.

27
Q

What is the treatment for testicular cancer?

A

Radical inguinal orchidectomy (offer sperm preservation and testicular prosthesis).

Re-check tumour markers 1-week post-op, if they were elevated.

Chase CT scan.

Further follow-up by an oncologist with chemotherapy as an adjuvant treatment even in non-metastatic cases.

28
Q

When performing a radical orchidectomy, why approach from the inguinal canal instead of the scrotum?

A

So as to not expose the scrotum to the excised cancer.

29
Q

What has a protective effect against penile cancer?

A

Circumcision.

30
Q

What are the types of penile cancer?

A

Squamous cell carcinoma (95%).

Kaposi’s sarcoma.

Basal cell carcinoma.

Malignant melanoma.

Sarcoma.

31
Q

What are the risk factors for penile cancer?

A

Phimosis (chronic inflammation).

Geography: Asia, Africa and South America.

HPV types 16 and 18.

Smoking.

Immunocompromised patients.

32
Q

What are the common sites of penile cancer?

A

Glans - 48%.

Prepuce - 21%.

Glans and prepuce - 9%.

Coronal sulcus - 6%.

Shaft - 2%.

33
Q

What is the common presentation of penile cancer?

A

Hard painless lump.

15-50% delayed presentation for >1 year due to embarrassment, neglect, fear, ignorance.

Urinary retention/groin mass (inguinal lymphadenopathy) - rare.

34
Q

What investigations are carried out for suspected penile cancer?

A

MRI scan to assess tumour depth.

CT scan abdomen, pelvis and chest in advanced disease.

35
Q

What is the treatment for prepucial penile cancer?

A

Circumcision.

36
Q

What is the treatment for glans penile cancer?

A

Superficial - glans resurfacing.

Deep - glansectomy.

37
Q

What is the treatment for advanced penile cancer?

A

Total penile amputation with the formation of perineal urethrostomy.

38
Q

What is the treatment for inguinal lymphadenopathy from penile cancer?

A

Inguinal lymphadenectomy if the lymph nodes are involved.

In high-risk penile cancers, this is also done, even when the lymph nodes are not involved.

2MBChB Renal (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions