Renal cell carcinoma Flashcards
Pathophysiology of renal carcionoma?
Forms from epithelial cells in proximal convoluted tubule of kidney.
The cells are called polygonal epithelial cell.
It can be genetic mutation on chromosome 3P, which cause a mutation on Von hippel lindau tumour supressor.
These mutations cause IGF-1 ( Growth factor) to increase causing dysregulated growth + Angiogenesis which causes tumours to form.
Risk factors of renal carcinoma?
Random
Oldermen
Smoker
Genetic (Von hippel lindau disease)
Hypertension
Diagnosis of renal carcinoma?
Staging with TNM system (1-4)
- T : Tumour size
- N: Degree of spread
- M: Degree of metasteses
Treatment of renal carcinoma?
Chemotherapy + radiation dont work
Resection surgery is done
Molecular targeted therapy
- Target VGF Receptor + cut of blood supply to tumour.
Symptoms of renal carcinoma?
P: Pain
I: Inflamation
P: Palpable mass
H: Hematuria
P: Paraneoplastic syndrome
- Increase erythropoetin = polycythemia
- Increase renin = Hypertension
- Increase PTH = Hypercalcemia
- Increase ACTH = Increase cortisol
What is von hippel lindau disease?
Inherited syndrome ( autosomal dominant)
Happens in younger men and woman
Normally affects both kidneys
What does the mutation in von hippel lindau disease cause?
Cysts + Benign Tumours formation
- Eyes
- CNS
- Main cause od death in VHL is Renal cell carcinoma