Renal Cancer

Question 1

Presentation of renal cancer

Answer 1

• RCC is most common kidney tumour
• Staged using TNM system
• Cannonball metastases are typical of RCC
• Presentation
  
  • Often asymptomatic
  • Haematuria
  • Vague loin pain
  • Non-specific symptoms of cancer (i.e. weight loss, fatigue, anorexia, night sweats)
• Risk factors
  
  • Smoking
  • Obesity
  • HTN
  • Long-term dialysis
  • Von Hippel-Lindau Disease

Question 2

Types of renal cancer

Answer 2

• Clear cell (75-90%)
• Papillary (10%)
• Chromophobe (5%)
• Collecting duct carcinoma (1%)
• Wilms Tumour (in children < 5 years old)

Question 3

Management of renal cancer

Answer 3

• Surgical (partial nephrectomy) +/- radiotherapy and chemotherapy depending on disease stage

Question 4

Paraneoplastic features of renal cancer

Answer 4

• Polycythaemia (RCC secretes unregulated erythropoietin)
• Hypercalcaemia (RCC secretes a hormone that mimics the action of PTH)
• Stauffer Syndrome (abnormal liver function tests demonstrating an obstructive jaundice – without any localised liver or biliary metastasis!)