Renal carcinoma

Question 1

Renal tumour in children?

Answer 1

Wilm’s nephroblastoma

Question 2

Where do renal cell carcinomas originate from?

Answer 2

Proximal renal tubular epithelium

Question 3

Most RCCs are described pathologically as what?

Answer 3

clear cell tumours

Question 4

Commonest familial cause of renal cell carcinoma?

Answer 4

Von Hippel Lindau syndrome

Question 5

Classic triad of RCC?

Answer 5

Haematuria, loin mass and loin pain

Question 6

How are RCCs commonly diagnosed now?

Answer 6

By CT or ultrasound when patients are being investigated for non-specific symptoms

Question 7

Sites of RCC metastases? (3)

Answer 7

Para-aortic lymph nodes
Lung- cannon ball secondaries
Osteolytic bone lesions

Question 8

Sites of RCC spread? (4)

Answer 8

Adjacent structures- adrenals, liver, spleen, pancreas

Question 9

Investigation of suspected RCC? (3

Answer 9

Ultrasound, CT
CXR
Bone scan

Question 10

Staging of RCC? (4)

Answer 10

Stage 1- confined to renal capsule
Stage 2- confined by Gotra’s perinephric facia
Stage 3- renal vein or local lymph node involvement
Stage 4- distant mets

Question 11

Management of renal cell cancer

Answer 11

Partial or total nephrectomy

Question 12

How might RCC present with a scrotal symptom?

Answer 12

Left varicocele