Renal, Penile and Testicular Cancer Flashcards
what mnemonic should be used when learning the pathology of a disease
in a surgeon’s gown a physician may make some progress
incidence age sex geographic aetiology predisposing factors macroscopic appearance microscopic appearance spread prognosis
what type of cancer affects the renal pelvis?
transition cell carcinoma
what imaging is best to differentiate a cyst from a solid mass?
USS
what imaging is best to differentiate a tumour from a haemorrhage?
MRI
Ix for benign renal cysts?
USS
contrast CT if concerned
Ix of angiomyolipoma?
CT
main complication of angiomyolipoma?
haemorrhage
an oncocytoma is a benign cancer T or F
T
what tumour presents with a central scar on CT?
oncocytoma
which benign renal tumour is the hardest to diagnose?
oncocytoma
classic triad of renal cell carcinoma?
loin pain
mass
haematuria
what paraneoplastic symptoms will patients with RCC present with?
weight loss
anaemia
hypertension
hypercalcaemia
why do patients with RCC present with loin pain?
necrosis of fat
bleeding into collecting system (clots in ureter)
why do you get hypercalcaemia in RCC?
make parathyroid peptide as these tumours are VERY metabolically active
RCC is a tumour of the ___
epithelium
young patient presents with multiple cysts and benign tumours….
von hippel lindau
inheritance of VHL?
autosomal dominant
if a young person presents with bilateral RCC what are they likely to have as well?
von hippel lindau syndrome
Ix of RCC?
USS
CT contrast
renal biopsy
Tx of RCC?
radical nephrectomy (adrenals spared)
partial nephrectomy
ablation
should you take out the adrenal gland in a nephrectomy?
no
main aim of a partial nephrectomy?
spare the nephron
a small renal mass is under _cm
4
Ix for a small renal mass?
renal biopsy - benign/malignant
what is BXO?
balanitis xerotica obliterans (white scarring of the foreskin)
presentation of BXO?
white patches
fissuring
bleeding
scarring
Tx of BXO?
dilation of meatal stenosis
circumcision
glans resurfacing
most common carcinoma in situ of penis?
squamous
appearance of squamous carcinoma in situ of penis?
erythroplasia of glans, prepuse or shaft
red velvety patces
Tx of squamous carcinoma in situ?
circumcision
topical 5-fluorocil
presentation of carcinoma of penis?
red raised area on penis
fungating mass
foul smelling
phimosis
what age is most commonly affected by penile carcinoma?
80yrs
cause of penile carcinoma?
HPV type 16
Ix of penile carcinoma?
biopsy
USS
physical examination
Tx of carcinoma of penis?
surgery- total/partial penectomy
LN biopsy if spread
radiotherapy
what lymph nodes can a penile carcinoma spread to?
inguinal lymph nodes
carcinoma of the penis is a squamous cell carcinoma T or F
T
testicular tumours are extremely painful T or F
F, painless and insensitive
where do testicular tumours metastasise to?
neck nodes
dyspnoea
gold standard Ix for testicular tumour?
USS
what investigations should be done to stage a testicular tumour?
CT abdo/thorax
CXR
give example of a testicular tumour?
seminoma
teratoma
HCG is raised in what testicular tumour?
teratoma mainly
what markers should be tested in a testicular tumour?
AFP
HCG
LDH
Tx of testicular tumour?
orchidectomy of testicle
peak age for a testicular tumour?
20-35yrs
risk is much greater if you had an undescended testis as a child T orF
T
what type of teratoma always has an elevated HCG level?
trophoblastic
