Renal Cell Carcinoma

Question 1

Define renal cell carcinoma.

Answer 1

Renal cell carcinoma (RCC) is renal malignancy arising from the renal parenchyma/cortex, and accounts for about 85% of renal cancers.

Question 2

Explain the aetiology/risk factors of renal cell carcinoma.

Answer 2

Smoking
Male sex
Age 55 to 84 years
Residence in developed countries
Black/American-Indian ethnicity
Obesity
Hypertension
Positive family history (FHx) of RCC
History of hereditary syndromes
History of acquired renal cystic disease

Question 3

Summarise the epidemiology of renal cell carcinoma.

Answer 3

The majority (85%) of renal malignancies are RCC (arising from the renal cortical parenchyma). RCC accounts for 2% to 3% of all new cancers globally, and, depending on geographic region and gender, is the 6th to 8th most common adult malignancy.

Question 4

Recognise the presenting symptoms of renal cell carcinoma. Recognise the signs of renal cell carcinoma on physical examination.

Answer 4

Asymptomatic (incidental finding)
Haematuria
Flank pain
Palpable abdominal mass

Question 5

Identify appropriate investigations for renal cell carcinoma and interpret the results.

Answer 5

FBC
LDH
Corrected calcium
Liver function tests (LFTs)
Coagulation profile
Creatinine
Urinalysis
Abdominal/pelvic ultrasound
CT abdomen/pelvis
MRI abdomen/pelvis