Renal cell carcinoma

Question 1

Most common kidney tumour that is an adenocarcinoma

Answer 1

Renal cell carcinoma (RCC)

Question 2

Origin of RCC

Answer 2

Renal tubules

Question 3

RFs of RCC

Answer 3

• smoking
• obesity
• hptn
• ESRF
• Von-hippel-Lindau disease
• tuberous sclerosis

Question 4

Wilm’s tumour is found in

Answer 4

Children <5

Question 5

Most common type of RCC

Answer 5

Clear cell carcinoma

Question 6

Other types of RCC

Answer 6

• papillary

- chromosphobe

Question 7

Triad of presentation of RCC

Answer 7

• haematuria
• flank pain
• palpable mass

Question 8

Common spread of RCC from renal vein to

Answer 8

IVC

Question 9

Cannonball metastasis originate form RCC and spread to

Answer 9

Lung metastasis

Question 10

Explain polycythemia in renal paraneoplastic syndrome

Answer 10

Unregulated secretion of EPO

Question 11

Explain hypercalcaemia in renal paraneoplastic syndrome

Answer 11

Ectopic secretions that mimic PTH

Question 12

Explain hypertension in renal paraneoplastic syndrome

Answer 12

• physical compression
• polycythaemia
• renin secretion

Question 13

Explain Stauffer’s syndrome in renal paraneoplastic syndrome

Answer 13

Abnormal LFTs without liver metastasis

Question 14

Criteria for two-week wait referral

Answer 14

• > 45

- unexplained visible haematuria

Question 15

Size and spread of stage 1 RCC

Answer 15

• <7cm

- confined to kidney

Question 16

Size and spread of stage 2 RCC

Answer 16

• > 7cm

- confined to kidney

Question 17

Spread of stage 3 RCC

Answer 17

• local spread

- not beyond Gerota’s

Question 18

Spread of stage 4 RCC

Answer 18

• beyond Gerota’s fascia

- metastasis

Question 19

Options for nephrectomy as part of 1st line surgical Mx

Answer 19

• partial nephrectomy

- radical nephrectomy

Question 20

If surgery is contraindicated the alternative options would be

Answer 20

• arterial embolisation
• percutaneous cryotherapy
• radio frequency ablation

Question 21

2nd line after surgery

Answer 21

Radio/chemo