Renal Cell Carcinoma Flashcards
What is renal cell carcinoma also known as? What does RCC arise from?
Hypernephroma
Arises from proximal renal tubular epithelium
What is the most common subtype of renal cell carcinoma?
Clear cell (75-85%)
(2nd Papillary 15%)
List 4 risk factors for RCC
SMOKING
Increasing age
Obesity
HTN
Name 2 conditions associated with RCC
Von Hippel-Lindau syndrome
Tuberous sclerosis
How does AD PKD affect risk of RCC?
Only slightly increased incidence
What is the classic triad of symptoms in RCC?
Haematuria
Loin pain
Abdominal mass
Only 10-15% present with all 3
Describe how RCC is usually diagnosed
> 50% diagnosed incidentally
Majority asymptomatic initially
What endocrine effects may be seen in RCC?
May secrete EPO: Polycythaemia
May secrete PTHrP: Hypercalcaemia
May secrete renin: HTN
May secrete ACTH: Hypercortisolism
What % of patients have mets at presentation in RCC?
25%
What may be found in a very small proportion of men with RCC?
Varicocele
(mostly L sided)
Due to tumour compressing veins
What is Stauffer syndrome?
aka paraneoplastic hepatic dysfunction syndrome
Non-metastatic hepatic dysfunction a/w RCC
Presents as cholestasis/ hepatosplenomegaly
Thought to be secondary to increased IL6
Which bloods are taken in suspected RCC? Which 2 are poor prognostic markers?
FBC
LDH: >1.5x normal
Calcium: >2.5 mmol/L
LFTs
U+Es
What initial imaging may be performed in suspected RCC?
Abdo/ pelvic USS
What imaging provides definitive diagnosis of RCC?
CT AP with contrast
(MRI AP if contrast CI)
Describe management of confined RCC
Partial or total nephrectomy depending on tumour size
T1 (<7cm): partial
