Renal Cell Carcinoma(RCC)

Question 1

what type of cancer is renal cell carcinoma(RCC)

Answer 1

adenocarcinoma

Question 2

describe the appearance of RCC

Answer 2

tan coloured, lobulated and solid

Question 3

where is RCC believed to arise from

Answer 3

proximal convoluted tubule

Question 4

what are the 3 most common histological appearances of RCC

Answer 4

conventional clear cell carcinoma(80%), papillary(10-15%), chromophobe(5%)

Question 5

what grading system is used for RCC

Answer 5

T1 to T4, T1 being <7cm, T4 being beyond Gerota’s fascia into surrounding structures

Question 6

what are the different aspects of the aetiology of RCC

Answer 6

M>F, smoking, renal failure/dialysis, obesity, hypertension, genetic

Question 7

describe the presentation of RCC

Answer 7

haematuria, loin pain, mass, pyrexia, varicocele, paraneoplastic syndrome

Question 8

what investigations are used for RCC

Answer 8

USS, CT(for staging), FBC, renal and liver functions

Question 9

what treatment options are there for small(<3-4cm) RCC

Answer 9

surveillance in elderly unfit, ablation in elderly fit/some younger, partial nephrectomy

Question 10

what treatment options are there for medium(>3-4cm) RCC

Answer 10

surveillance, ablative techniques, partial nephrectomy, radial nephrectomy

Question 11

what are the treatment options are there for large(>7cm) RCC

Answer 11

radical nephrectomy, laparoscopic approach is gold standard