Renal cell carcinoma

Question 1

Pathophysiology of renal carcionoma?

Answer 1

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.

Question 2

Risk factors of renal carcinoma?

Answer 2

Random
Oldermen
Smoker
Genetic (Von hippel lindau disease)
Hypertension

Question 3

Diagnosis of renal carcinoma?

Answer 3

Staging with TNM system (1-4)
- T : Tumour size
- N: Degree of spread
- M: Degree of metasteses

Question 4

Treatment of renal carcinoma?

Answer 4

Chemotherapy + radiation dont work

Resection surgery is done

Molecular targeted therapy
- Target VGF Receptor + cut of blood supply to tumour.

Question 5

Symptoms of renal carcinoma?

Answer 5

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

Question 6

What is von hippel lindau disease?

Answer 6

Inherited syndrome ( autosomal dominant)

Happens in younger men and woman

Normally affects both kidneys

Question 7

What does the mutation in von hippel lindau disease cause?

Answer 7

Cysts + Benign Tumours formation
- Eyes
- CNS
- Main cause od death in VHL is Renal cell carcinoma