Renal Cell Carcinoma

Question 1

Clinical presentation of renal cell carcinoma?

Answer 1

Haematuria
Flank/loin pain
Palpable renal mass
Non specific sx: weight loss, fatigue, night sweats

Canonball metastases- clearly defined circular opacities scattered through lungs on CDR

Question 2

Risk factors for renal cell carcinoma?

Answer 2

Smoking
Male sex
Over 55 yrs
Obesity
HTN
Positive family hx of renal cancer

Question 3

Investigation findings for renal cell carcinoma?

Answer 3

Raised corrected calcium
Raised LDH in advanced cancer
Derranged LFTs may indicate liver metasteses
Creatinine may be raised

Urinalysis: haematuria and/or protinuria

Question 4

How to diagnose renal cell carcinoma?

Answer 4

Usually initially diagnosed with ultrasound BUT cannot assess cystic masses with USS alone.

IF lesions detected then indicates CT abdo/pelvis

MRI used for staging patients where contrast dye contraindicated

Question 5

What paraneoplastic features are associated with renal cell carcinoma?

Answer 5

Polycythaemia: due to secretion of unregulated erythropoietic

Hypercalcaemia

Hypertension

Stauffer’s syndrome: abnormals LFTs without liver metastases

Question 6

Management of renal cell carcinoma?

Answer 6

Surgery to remove tumour is first line

If not suitable for surgery: artial embolisation, percutaneous cryotherapy, radiofrequency ablation, chemo, radio