renal cell carcinoma

Question 1

types of renal cell adenocarcinoma

Answer 1

clear cell (80%)
papillary (15%)
chromophobe (5%)
Wilm’s tumour affecting kidney in children under 5

Question 2

risk factors for renal cell carcinoma

Answer 2

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

Question 3

presentation of renal cell carcinoma

Answer 3

asymptomatic
haematuria
loin pain
non-specific signs of cancer
palpable renal mass

Question 4

spread of renal cell carcinomas

Answer 4

tissues around the kidenys- Gerota’s fascia
- renal vein then to inferior vena cava
- cannonball metastases in the lungs

Question 5

paraneoplastic features

Answer 5

polycythaemia- due to secretion of erythropoietin
hypercalcaemia
hypertension
stauffer’s syndrome (abnormal LFTs)

Question 6

staging of renal cell carcinoma

Answer 6

CT CAP used
TNM

Question 7

management of renal cell carcinoma

Answer 7

partial nephrectomy (tumour <7cm and completely confined to the kidney)

**radical nephrectomy - most effective management

if patient not suitable for surgery:
- arterial embolisation
- percutaneous cryotherapy
- radiofrequency ablation