Renal cancer Flashcards
Where is renal cell carcinoma most common?
developed countries
What percentage of renal malignancies are RCC?
85%
Apart from RCC what are the other renal malignancies?
TCC (Urothelial tumour) nephroblastoma in children and SCC
Why do renal SCC occur?
Chronic inflammation second to renal calculi, infection and schistosomiasis
What is RCC?
Adenocarcinoma of the renal cortex
Where does RCC arise from?
PCT, usually in the upper pole of the kidney
What cells are RCC usually composed of?
Polyhedral clear cells, with dark stained nuclei and cytoplasm rich with lipid and glycogen grails
How do RCC spread?
direct invasion into the perinephric tissues, adrenal gland and renal vein or inferior vena cava
Lymphatics to pre-aortic and hilar nodes and haematogenous spread to the bones, liver, brain and lungs
What is tumour thrombosis?
where the RCC invades through the renal vein wall into the lumen
What risk factor doubles the risk of RCC?
Smoking
What other risk factors are there for RCC?
industrial exposure to carcinogens, dialysis (x30) hypertension, obesity, anatomical abnormalities like polycystic kidneys and horseshoe kidneys and genetic conditions
What is the most common clinical feature of RCC?
Haematuria (visible or non-visible)
What other clinical features are there of RCC?
Flank pain, flank ass or non specific symptoms like lethargy and weight loss
What is the classic triad for RCC?
Haematuria, mass and flank pain
What percentage of people present with the classic triad for RCC?
15%