renal cell carcinoma

Question 1

what

Answer 1

type of adenocarcinoma arising from renal tubules

Question 2

classic traid

Answer 2

haematuria
flank pain
palpable mass

Question 3

types of RCC

Answer 3

clear cell (80%)
papillary (15%)
chromophobe (5%)

Question 4

wilms tumour

Answer 4

specific type of tumour affecting kidney in kids , esp <5yrs

Question 5

risk factors

Answer 5

smoking
obesity 
hypertension 
end stage renal failure 
tuberous sclerosis 
von hippel lindau disease

Question 6

presentation

Answer 6

haematuria
loin pain
fatigue, weight loss, night sweats

palpable mass OE

Question 7

2 week wait referral for…

Answer 7

> 45yrs with unexplained heamaturia

either w/o UTI or persisting after UTI Rx

Question 8

spread

Answer 8

spreads to tissues aorund kidney within gerota’s fascia.
often renal vain then IVC

cannonball metastases in lung

Question 9

cannonball metastases

Answer 9

lung metastasis

renal cell carcinoma 
choriocarcinoma 
prostate cancer
bladder cancer
endometrial cancer

Question 10

paraneoplastic feautres

Answer 10

polycythemia
hypertension
hypercalcaemia
stauffer’s syndrome

Question 11

stauffer’s syndrome

Answer 11

abnormal LFTs w/o liver mets

Question 12

staging scan

Answer 12

CT TAP

Question 13

stage 1

Answer 13

< 7cm confined to kidney

Question 14

stage 2

Answer 14

> 7cm confined to kidney

Question 15

stage 3

Answer 15

spread within gerota’s fascia

Question 16

stage 4

Answer 16

spread outwith gerota’s fasica

Question 17

first line Mx

Answer 17

surgery to remove tumour if possible

partial nephrectomy
radical nephrectomy

Question 18

Mx - not suitable for surgery

Answer 18

arterial embolisation
percutaneous cryotherapy
radiofrequency ablation

chemo and radiotherapy may also be used