Renal cell cancer Flashcards
Definition
Adenocarcinoma of the proximal convoluted tubule
Common presentation
Incidental finding on imaging
- often patient is asymptomatic
Who gets it
Elderly
Males
Obesity (central)
Smoking
Types
Clear cell
Papillary
Chromophobe
Collecting duct
Which type of RCC is most common?
Clear cell
Types - clear cell
Large vacuoles in the cytoplasm
Which type of RCC is the most aggressive?
Collecting duct
Pathology
Large well circumscribed mass on the cortex
Yellow
Solid, cystic, necrotic and haemorrhage areas
Renal tumours have the ability to neovascularise - true or false?
True
Clinical features
Asymptomatic Abdominal mass Haematuria Flank pain Weight loss
Paraneoplastic manifestations
Polycythaemia
- tumour secretes erythropoietic which stimulates RBC formation
Hypercalcaemia
What does RCC secrete?
Erythropoetin
Investigations
US
X-ray - cannon ball mets
CT contrast
Biopsy - not indicated in all pts
Which staging is used
Robson
Spread?
Lymphatic
Haematogenous
Usually grows into the renal hilum -> invades veins -> IVC -> heart -> lungs
Metastasis to ____ is most common?
Lungs
Management (high risk)
Radical nephrectomy
Adrenal glands are routinely removed in surgery? true or false
FALSE
- only removed if diseased
Management (low-mod risk)
Partial nephrectomy
Management (low risk)
RF ablation
Cryoablation
Management (metastatic disease)
Tyrosine kinase inhibitors
VEGF or PDGF inhibitors
Associated conditions
Von Hippel Lindau syndrome
- young pt
- multiple tumours
- AD
Nephroblastoma (wilms tumour) - definition
Commonest intra-abdominal tumour in children
