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Urinary clinical conditions > Renal Cell Carcinoma > Flashcards

Renal Cell Carcinoma Flashcards

1
Q

What is the presentation of renal cell carcinoma?

A

Majority of patients present asymptomatic
Some may present with symptoms from metastatic disease
Classic triad of symptoms: flank pain, haematuria and abdominal mass occurs in < 10%
Other symptoms someone may experience include: abdo pain, haematuria, oedema/ascites, scrotal varicocele (in males), weight loss, sweats, fever

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2
Q

What is the classic triad of symptoms from renal cell carcinoma?

A

Flank pain
Haematuria
Abdominal mass

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3
Q

What are the risk factors for renal cell carcinoma?

A 
Male sex
Age > 55 - 84 yrs old
Smoking 
Obesity
Hypertension
Possitive FH of RCC
History of accquired renal cystic disease
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4
Q

What are 2 benign renal tumours?

A

Oncocytoma

Angiomyolipoma

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5
Q

Where does majority of renal carcinomas arise from?

A

Proximal tubules

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6
Q

What are the histological subtypes of renal carcinoma?

A

Clear cell
Papillary
Chromophobe
Bellini type ductal carcinoma

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7
Q

What investigations would you carry out if you suspected renal cell carcinoma?

A 
CT scan abdomen and pelvis (diagnosis &amp; TNM staging)
FBC, LFT’s, creatinine
Urinalysis
USS (differentiate tumour form a cyst)
MAG-3 or DMSA
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8
Q

What staging is used for renal cancer?

A

TNM staging

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9
Q

Via what ways can renal carcinoma spread?

A

Direct spread through renal capsule
Venous invasion to renal vein and IVC
Haematogenous spread to lungs and bone
Lymphatic spread to paracaval nodes

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10
Q

What is the treatment for renal carcinoma?

A

Laparoscopic radical nephrectomy
Palliative cytoreductive nephrectomy (met disease)
Multi-targeted receptor kinase inhibitors
Immunotherapy

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11
Q

What is the treatment for metastatic renal carcinoma?

A

Palliative cytoreductive nephrectomy is beneficial - prolongs median survival by 6 months
Little treatment since RCC is chemo and radio resistant

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12
Q

What is the prognosis of T1, T2, T3, T4 renal cell carcinoma?

A 
T1 = 95%
T2 = 90%
T3 = 60%
T4 = 20%
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13
Q

What is the prognosis for a patient who has metastatic renal carcinoma?

A

Median survival 12-18 months

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14
Q

What is the prognosis for a patient who has N1 or N2 staged renal carcinoma?

A

5 yr survival 20%

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15
Q

What are some of the paraneoplastic syndrome presentations from renal cell carcinoma?

A 
Anorexia
Cachezia
Pyrexia
Hypertension
Hypercalcaemia
Abnormal LFT’s
Anaemia
Polycythaemia
Raised ESR
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Urinary clinical conditions (17 decks)

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