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Renal > Renal Cancer Lecture > Flashcards

Renal Cancer Lecture Flashcards

1
Q

One of the most common tumors of childhood
A malignancy derived from the primitive cells of renal cortex
* Average age of diagnosis is 38mths , usally between 3-5yrs of age

A

Wilms Tumor (Nephroblastoma)

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2
Q 
Large abdomen 
Often asymptomatic 
Some pain with vomiting 
Hematuria 20-25%
some have HTN
A

Wilms Tumor

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3
Q

25% have genetic anomalies

  • absence of iris: aniridia
  • enlargement of 1 side of face
  • genitourinary complications
A

Wilms Tumor

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4
Q

Image of choice for Wilms Tumor

A

CT scan

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5
Q

Should you biopsy Wilms tumor?

A

NO! …risk of spreading Ca to surrounding tissue!!

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6
Q

Management of Wilms tumor..

A

Surgery/chemo and sometimes radiation

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7
Q

Usually good if caught early before METS

Good response to Tx with 90% 5 yr survival rate-dependent on staging and treatment

A

Wilms tumor

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8
Q

flank pain, palpable flank mass, & painless hematuria

A

Renal cell carcinoma

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9
Q

Rare to have presentation of full TRIAD. (Only 9%)
Often incidental finding on other imaging work-up.
Other – weight loss, malaise, anemia, hypertension, hypercalcemia, recurrent fevers

A

Renal cell carcinoma

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10
Q 
Risk Factors:
SMOKING 
Age 50-70 yrs of age higher
Male sex
Obese
Prolonged exposure to asbestos, cadmium, or petroleum products
Hx of Tuberous Sclerosis
Von Hippel-Lindau Dz.- family Hx , genetic 
Long term dialysis
A

Renal cell carcinoma

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11
Q

Usually grows shperical , well circumscribed mass in the cortex of the kidney
Arises from the epithelial lining of proximal tubule
Grow into renal vein, inferior vena cava , and occlude the right side of heart- (L/E edema & ascites)

A

Renal cell carcinoma

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12
Q

Work-up:
Incidentally find it on routine work-up of for something else:
Urinalysis: microscopic (hematuria)- may not always show initially- re-test if suspicious
Ultrasound, CT
CT 91% accuracy in Staging RCC
MRI- if concern for METS, review of adjacent structure

A

Renal cell carcinoma

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13
Q

To definitively diagnose renal cell carcinoma you need…..

A

a biopsy

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14
Q

Slow growing- often does not present until advanced
Common Sites of Metastasis
Lung, Lymph nodes, Bone, Liver, Brain

A

Renal cell carcinoma

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15
Q

First-Line Treatment is Surgical Eradication- ONLY CURE
either by resection or by ablating with cryotherapy, or embolization of the areteries to deprive of O2 supply (for LARGE tumors)

A

Renal cell carcinoma

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16
Q

Renal cancer stage I-III, treat with…

A

Resection

17
Q

Renal cancer stage IV, treat with..

A

palliative tx

18
Q

TNM and Robson..

A

Used to stage renal cancer

19
Q

is the most common type of kidney cancer (9 out of 10 cases). RCC usually begins as a tumor within a kidney; however, sometimes there can be more than one tumor or even tumors in both kidneys. These tumors can grow to be very large, but are usually found before they spread to other parts of the body.

A

Renal cell carcinoma

20
Q

is the most common subtype within RCC (7 out of 10). Cells of this type appear clear or pale under the microscope.

A

Clear cell renal cell carcinoma

21
Q

is the second most common, making up 10%. This type produces “finger like” projections on the tumor.

A

Papillary renal cell carcinoma

22
Q

makes up around 5% of RCC cases. Cells of this type are also clear, but are much larger with other distinguishing features.

A

Chromophobe renal cell carcinoma

23
Q

don’t start in the kidney itself, but instead begin in the renal pelvis (where the urine goes before it enters the ureter).

A

Transitional cell carcinoma

24
Q

Risk Factors:
SMOKERS- half the cases
Chemical exposure- aniline dyes (leather woodwork)

A

Transitional cell carcinoma

25
Q

Cancer of the mucosal lining of the bladder
Renal pelvis, Ureters , Urethra, where transitional cells exist
*Proliferation of cells along fibrovascular core
*Papillary pattern of growth- low or high grade, viewed under microscope

A

Urothelial carcinoma

26
Q

What type of urothelial carcinoma does not invade submucosa- irregular red spots on cytoscopy

A

Urothelial carcinoma in situ

27
Q

Presentation: PAINLESS hematuria- typical
Similar to Renal Cell presentation
May have more back pain
If involving the ureters/bladder may have dysuria

A

Urothelial carcinoma

28
Q

Diagnosis of urothelial carcinoma

A

Cytoscopy and biopsy

29
Q

Treatment:
Carcinoma InSitu and low grade papillary can be tx with immune therapy Bacillus Calmette –Guerin (BCG)- ???
Recurrent CIS or invasive urothelial carcinoma- resection of part or all of the invovled bladder
Can create new bladder from intestine
Urostomy bag- to store urine

Resection and Chemo

A

Urothelial carcinoma

30
Q

Prognosis:
Grade and Tumor Dependent
Most detected at early stage amendable to Tx :
Transurethral resection, fulguration, intravesicle immune therapy
80% of Tumors will recur
Monitor- cytology of urine – frequent almost 100% survival
Muscle invasive carcinoma drops to 60% 5yr Survival

A

Urothelial carcinoma

31
Q

Cancerous cells in the inner lining tissue of the bladder.

A

Stage 0

32
Q

Tumor has spread to the bladder wall.


A

Stage 1

33
Q

Tumor has penetrated the inner wall and is present in muscle of the bladder wall.

A

Stage 2

34
Q

Tumor has spread through the bladder to fat around the bladder.


A

Stage 3

35
Q

Tumor has spread to the wall of the pelvis or abdomen, to the lymph nodes, or to areas away from the bladder such as the lungs, liver, or bones.

A

Stage 4

Renal (15 decks)

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