Renal Cell Carcinoma

Question 1

What is the classical metastasis of RCC?

Answer 1

•“Cannon ball metastases” in the lungs are a typical (and common exam question) of metastatic renal cell carcinoma

Question 2

Presentation

Answer 2

• Often asymptomatic
• Haematuria
• Vague loin pain
• Non-specific symptoms of cancer (e.g. weight loss, fatigue, anorexia, night sweats)

Question 3

Types

Answer 3

• Clear cell (75-90%)
• Papillary (10%)
• Chromophobe (5%)
• Collecting duct carcinoma (1%)

Question 4

RF

Answer 4

Smoking
•Obesity
•Hypertension
•Long-term dialysis
•Von Hippel-Lindau Disease

Question 5

Management

Answer 5

• Surgery (partial nephrectomy first line)

* /- radiotherapy and chemotherapy depending on disease stage.

Question 6

Paraneoplastic features?

Answer 6

• Polycythaemia (RCC secretes unregulated erythropoietin)
• Hypercalcaemia (RCC secretes a hormone that mimics the action of PTH)
• Stauffer Syndrome (abnormal liver function tests demonstrating an obstructive jaundice – without any localised liver or biliary metastasis!)