Renal, Penile and testicular cancer Flashcards
What is the typical presentation of renal cell carcinomas ?
- Loin pain
- Renal mass
- Haematuria
- Malignancy signs - Weight loss, anaemia, hypercalcaemia
How are renal cell carcinomas diagnosed ?
- USS - good initial test
- CT - this is diagnostic
What is the treatment of renal cell carcinomas ?
1st line = Radical Nephrectomy
Metastatic:
- IL2
- Interferon alpha
- Sunitinib
What is the premalignant lesion affecting the penis ?
Balanitis xerotica obliterans (linchen sclerosus)
Describe the presentation of Balanitis xerotica obliterans (linchen sclerosus)
Causes white patches, fissuring, bleeding. scarring
What is the main type of cancer affecting the penis ?
Squamous cell carcinoma
What is meant by a carcinoma in situ ?
Means that the cells of these cancers are still only in the epidermis (the upper layer of the skin) and have not invaded into deeper layers.
What are the 2 classes of carcinoma in situ which affect the penis ?
- Erythroplasia of Queyrat
- Bowens disease
How do Erythroplasia of Queyrat and bowens disease present on the penis ?
Red velvety patches
When is a squamous cell carcinoma in situ on the penis classified as bowens disease and when is it classified as Erythroplasia of Queyrat?
Erythroplasia of Queyrat = on the Glans, prepuce or shaft of penis
Bowens disease = Remainder of genitalia
What is the treatment for squamous cell carcinomas in situ (bowens or erythroplasia of queryat) of the penis ?
- If prepuce alone - circumcision
- If not - Topical 5 fluorouracil
How do squamous cell carcinomas of the penis typically present ?
- Red raised area penis
- Fungating mass, foul smelling
- Phimosis
How is a squamous cell carcinoma of the penis diagnosed ?
- Physical exam
- Cytology or histological diagnosis
What are the risk factors for developing a squamous cell carcinoma of the penis ?
- Peak incidence 80 yrs of age
- HPV (16)
Where do tumours of the penis most commonly affect ?
The glans or prepuce
What is the treatment for carcinomas of the penis ?
- Total/ partial penectomy
- Sentinel Biopsy
- Inguinal lymphadenectomy
What are the main types of tumours affecting the testicles and what cells do they arise from ?
- Seminomas and teratomas
- Arise from germ cells
How do testicular tumours often present ?
Painless, insensitive testicular swelling
How are testicular tumours diagnosed ?
- US
- and tumour markers (covered in pathology lecture)
What is the main risk factor for testicular tumours ?
Undescended testis - increases the risk x 30
What are the different classes of teratomas ?
- Differentiated
- Intermediate
- Undifferentiated
- Trophoblastic
What lymph nodes do testicular tumours tend to metastaise to ?
Para-aortic lymph nodes
What is the treatment of testicular tumours ?
- For seminoma - use radiotherapy
- For teratoma - use chemotherapy
Then should do orchidectomy (remove testicle)
