Renal Cell Carcinoma

Question 1

Which renal cells does renal cell carcinoma arise from?

Answer 1

Proximal renal tubular epithelium

Question 2

What are some risk factors for the development of renal cell carcinoma?

Answer 2

• Smoking
• Obesity
• Hypertension
• FHx
• Acquired polycystic kidney disease

Question 3

What are the likely history/examination findings in a patient with renal cell carcinoma?

Answer 3

• Risk factors
• None (50% incidental)
• Flank pain
• Haematuria
• Palpable abdominal mass
• Paraneoplastic effects
  
  • Hepatic dysfunction signs
  • Lower limb oedema

Question 4

What investigations might be appropriate in someone suspected of renal cell carcinoma?

Answer 4

• Renal US/CT (primary)
• LFTs/bone scan/CXR (mets)
• FBE/ESR/UEC/CMP (paraneoplastic effects)

Question 5

What are the management prinicples for patients with renal cell carcinoma?

Answer 5

• Surveillance
• Surgical resection/radical nephrectomy
• Targeted molecular therapy (metastatic disease)