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Renal and Urology > renal, penile and testicular cancer > Flashcards

renal, penile and testicular cancer Flashcards

1
Q

renal tumours

A
  1. renal cell carcinoma
  2. oncocytoma
  3. angiomyolipoma
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2
Q

benign renal tumours

A

renal cysts, oncocytoma, angiomyolipoma, adenoma and fibroma

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3
Q

malignant renal tumours

A

renal cell carcinoma

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4
Q

embryonic renal tumour

A

nephrobalstoma (otherwise known as wilms tumour)

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5
Q

most common presentation of renal tumours

A

found incidentally on ultrasound

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6
Q

benign renal cysts

A

extremely common and the vast majority are benign, the increased the complexity of the cyst the more likely it is to be malignant

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7
Q

angiomyolipoma

A

benign tumour which contains blood vessels, fat and muscle

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8
Q

although angiomyolipoma is benign there is a risk of

A

haemorrhage

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9
Q

angiomyolipomas are diagnosed using

A

CT to measure the density of the lesion which is reported in hounsefield units

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10
Q

how many hounsefiedl units is diagnostic of an angiomyolipomas

A

greater than 10

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11
Q

angiomyolipomas between 4-6cm

A

have a risk of spontaneous haemorrhage which can caused wunderlichs syndrome which is massive retro-peritoneal bleeding which can be fata therefore lesions of this size are embolized

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12
Q

oncocytoma

A

benign renla tumour however, it cannot be differentiated from a renal cell carcinoma until after nephrectomy

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13
Q

on ct of an oncocytoma

A

there is a central scar

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14
Q

renal cell carcinoma classic triad

A
  • renal mass
  • frank haematuria
  • loin pain
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15
Q

frank haematuria is

A

urothelial carcinoma until proven otherwise however, after you have ruled it out part to rule out things like renal cell carcinoma

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16
Q

renal cell carcinoma is a common cause of

A

paraneoplastic sydnromes

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17
Q

renal cell carcinomas

A

arise from the epithelial cells of the proximal convoluted tubule

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18
Q

renal cell carcinoma most common type

A

clear cell

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19
Q

multi-focal or bilateral renal cell carcinoma should shout out

A

VON HIPPEL LINDAU SYDNROME

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20
Q

Diagnosis of renal cell carcinoma

A

triple phase contrast CT which shows enhancement

21
Q

why is biopsy not carried out for renal cell carcinomas

A

because it doesn’t let you differentiate between a renal cell carcinoma and an oncocytoma

22
Q

Do renal cell carcinomas commonly extend outside the renal capsule

A

no they commonly spread into the renal veins and to the inferior vena cava where they metastasise to the lungs and bones

23
Q

treatment of renal cell carcinoma

A

gold standard is a radical nephrectomy where the whole kidney is removed as well as gerotas fascia but the adrenal gland is left in place unless it is involved

24
Q

renal cell carcinomas are not responsive to what

A

radiotherapy

25
Q

management of metastatic disease in renal cell carcinoma

A

surgery is still carried out where possible and tyrosine kinase inhibitors such as sunitinib

26
Q

pre-malingnat cutaneous penile conditions

A
  • balanitis xerotica obliterates and leukoplakia
27
Q

spumous cell carcinoma of the penis is either

A

squamous cell carcinoma in situ or invasive squamous cell carcinoma

28
Q

balanitis xerotica obliterans is also known as

A

lichens sclerosis et atrophicus

29
Q

balnaitis xerotic obliterates usually present with

A

tight foreskin which cannot be retracted with a white demarcated line, causes fissuring and bleeding

30
Q

management of balanitis xerotica obliterates

A

circumcission

31
Q

balanitis xerotica obltierans has

A

a very low risk of becoming malignant and circumcission reduces this risk

32
Q

squamous cell carcinoma in situ presentation

A

red velvety patches on the pic or under the foreskin which do not go away

33
Q

squamous cell carcinoma in situ should be differentiated from

A

zoons ballonitis which only causes redness

34
Q

sqauous cell carcinoma in situ affecting the gland, prepuce or shaft is known as

A

erythropalsia of query

35
Q

anywhere else on the penis is known as

A

bowens disease

36
Q

treatment of squamous cell carcinoma in situ

A

if only the prepuce is involved circumcission but if any other part of the penis is involved topical- 5-fluoracil-

37
Q

invasive squamous cell carcinoma of the penis is often

A

a delayed presentation and present with a foul smell and phimosis

38
Q

diagnosis of invasive spumous cell carcinoma of the penis

A

ultrasound and MRI

39
Q

lymphadenopathy in invasive squamous cell carcinoma of the penis is

A

inguinal as the penis drains to the superficial inguinal nodes

40
Q

treatment of penis squamous cell carcinoma

A

partial or total penectomy and sentinel node biopsy

41
Q

testicular tumours

A

germ cell tumours:

  • seminoma
  • non-seminomatous germ cell tumours= teratomas, embryonal yolk sac and choriocarcinoma(all stem cell tumours)
  • intra-tubule germ cell neoplasms
42
Q

presentation of testicualr tumours

A

painless tessticualr swelling which is stony hard

43
Q

do testicualr tumours metastasise

A

yes 10% of people present with metastasis with supra-clavicular metastasis common

44
Q

diagnosis of testicualr tumours

A

ultrasound

45
Q

what else does a testiualr tumour require before carrying out surgery

A

chest x-ray to look for cannonball metastases

46
Q

tumour markers measures before surgery

A
  • alpha foeto protein (AFP)= IS never elevated in a seminoma
  • beta-HCG= elevated in 10% seminomas and 60% of teratomas and is ALWAYS ELEVATED IN TROPHOBLAST TUMOURS
  • LDH= used to measure tumour burden
47
Q

treatment of testicualr tumour

A

orchidectomy through inguinal access and high ligation of the cord with insertion of a prosthetic testicle

48
Q

what is measured after orchidectomy

A

tumour markers

49
Q

where do the testis drain lympahticallt

A

to the para-aortic lymph nodes therefore, you cannot palpate lymph nodes in testicualr tumours

Renal and Urology (51 decks)

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