Renal Cancer Flashcards
What type of cancer do you get in the kidney
Renal cell carcinoma
Where and at what age is the incidence of RCC higher
Developed countries
Peak incidence - 50-70yrs
What are the other renal malignancies
TCC
Nephroblastoma in children
Squamous cell carcinomas - secondary to renal calculi/infection from schistosomiasis
Which histological type of cancer is a renal cell carcinoma
Adenocarcinoma of the renal cortex
Where do RCC primarily arise from
PCT mostly in the upper pole of the kidney
Where can RCC spread through direct invasion
Perinephric tissues
Adrenal glands
Renal vein ( if it spreads here its called tumor thrombosis )
IVC
where can RCC spread to via lymphatics
Pre-aortic
Hilar
Where can RCC spread through the blood
Bones
Liver
Brain
Lung
What are the risk factors of RCC
Smoking
Industrial exposure to carcinogens - lead, cadmium, aromatic hydrocarbons
Dialysis
Hypertension
Obesity
Polycystic kidney disease
Horseshoe kidneys
Von hippel - Lindau
What are the clinical features of RCC
Haematuria- visible/non visible
Flank pain/mass
Lethargy
Weight loss
Classic triad:
- haematuria
- flank pain
- mass
Why may patients with RCC have a varicocele
Left-sided masses may present with a left varicocoele, due to compression of the left testicular vein as it joins the left renal vein.
What are some of the paraneoplastic syndromes associated with RCC
Paraneoplastic syndromes caused by ectopic secretion of hormones by RCC can lead to uncommon presentations include polycythaemia due to erythropoetin, hypercalcaemia due to parathyroid hormone, hypertension due to renin, or pyrexia of unknown origin
What are the differential diagnoses
Other Urological malignancies
UTI
Renal stones
Which lab tests must be ordered for the investigation of RCC
Routine bloods - FBC, U&Es, calcium, LFT, CRP
Urinalysis
What are the imaging tests needs for investigation of RCC
USS
CT abdo/pelvis scan - pre and post contrast is gold standard
If confirmed then additional CT CAP needed for staging
