Renal cell carcinoma

Question 1

what are the most common histological type in RCC

Answer 1

Clear cell (75 %)

Question 2

RF for RCC

Answer 2

smoking, obesity, htn, loop diuretics, dialysis, aquired cystic disease. renal transplant, analgesics, MEN 40-60 YOA

Question 3

presentation of RCC

Answer 3

hematuria, pain, mass.

Question 4

imaging in RCC

Answer 4

USG, CT is gold standard in staging. MRI when infiltration of IVC.

Question 5

Staging of RCC

Answer 5

TNM

Question 6

VHL mutation on RCC

Answer 6

framshift, deletion, promoter methylation.

Question 7

Radical treatment of RCC

Answer 7

SURGERY (exam) and have NO benefit of adjuvant therapy

Question 8

what is radical nephrectomy

Answer 8

kidney + adrenal + regional LN

Question 9

prognostic factors RCC

Answer 9

histolog + cytology, furham grade, nuclear grade, size, necrosis, PS, clinical presentation.

Question 10

where does RCC metastasize

Answer 10

heart, skin, subcutanoeus, genitals,

Question 11

systemic treatment in RCC

Answer 11

cytokines: HD: IL2, IFN alpha,
VEGF pathway: bevazucimab, iber
mTOR: inhibitors (temsirolimus = in pts with poor prognosis)

Question 12

when to do partial nephrectomy in RCC

Answer 12

when cencer is under

Question 13

heng criteria?

Answer 13

RCC metatatic disease. poor prognostic factors.

- KPS

Question 14

targeted therapy SE

Answer 14

HFS, hypothyroidism. HTN, (treatment with ACEI)