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My2 renal > Renal, Testicular and Penile cancer > Flashcards

Renal, Testicular and Penile cancer Flashcards

1
Q

name some common benign renal tumours

A

angiomyolipoma, oncotyoma, fibroma (medulla), adenoma (cortex), juxtaglomerular tumour, cysts

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2
Q

name some common malignant renal cancers

A

renal cell carcinoma, transitional cell carcinoma, lymphoma

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3
Q

what is the most common renal cancer affecting children

A

Wilm’s tumour (nephroblastoma)

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4
Q

what age group commonly gets Wilm’s tumour and what mutation can cause it

A

ages 3-4, WT1 mutation

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5
Q

who commonly gets angiomyolipoma (AML)

A

middle aged females with tuberous sclerosis (80% will go on to develop AML)

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6
Q

what is tuberous sclerosis

A

autosomal dominant disease that causes benign tumours to grow all over the body

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7
Q

what are symptoms of AML

A

50% incidental finding, loin pain, haematuria, mass, Wunderlich’s syndrome (retroperitoneal bleed)

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8
Q

what investigations are done for AML and what is seen on each

A

biopsy: blood vessels, immature smooth muscle, fat // USS: bright echo pattern // CT: fatty tumour

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9
Q

what is the treatment for AML

A

surgery: embolisation + partial/ emergency nephrectomy

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10
Q

what are oncocytomas

A

spherical, capsulated, brown tumours that are radiologically similar to renal cell carcinomas (but do NOT met)

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11
Q

what is seen histologically in oncocytomas

A

eosinophilic cells with lots of mitochondria

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12
Q

what investigations are done for oncocytoma

A

CT: spoke wheel pattern // 85% are incidental findings

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13
Q

how do you treat oncocytomas

A

same management as renal cell carcinomas

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14
Q

where do renal cell carcinomas (RCC’s) arise

A

proximal convoluted tubules in the renal cortex

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15
Q

what are risks factors for developing RCC

A

male, renal failure, obesity, hypertension, VHL syndrome

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16
Q

what % of RCCs contain cysts

A

10-25%

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17
Q

what are the 5 histological classifications of RCCs

A

clear cell (80%), papillary (10-15%), chromophobe (5%), (collecting ducts and medullary cells)

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18
Q

what is seen on biopsy of clear cell RCCs

A

clear cytoplasms rich in glycoproteins

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19
Q

what is a big risk factor for clear cell RCC

A

obesity (and deletion on chromosome 3)

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20
Q

what is seen on biopsy of papillary RCCs

A

elongated papillae with foamy cells

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21
Q

what is seen on biopsy of chromophobe RCCs

A

large cells with defined borders

22
Q

who is commonly affected by collecting duct RCCs

A

young patients - is rare, aggressive and has a poor prognosis

23
Q

what is a grade 1 RCC

A

<7cm

24
Q

what is a grade 2 RCC

A

> 7cm but confined to kidney

25
Q

what is a grade 3 RCC

A

beyond kidney –> renal vein, perinephric fat, IVC

26
Q

what is a grade 4 RCC

A

beyond gerotas fascia (fascia that encapsulates the kidney)

27
Q

what is a common presentation of renal carcinoma

A

haematuria, loin pain and loin mass

28
Q

what other symptoms can be seen in RCC

A

pyrexia, varicocele (testes vein enlargement), paranoplastic syndrome

29
Q

what is paraneoplastic syndrome and what symptoms are seen in RCC

A

autoimmune disorders in response to neoplasms: anaemia, cushing’s, hypertension

30
Q

what investigations are done for RCC

A

USS, CT, FBC, renal and LFTs

31
Q

how would you manage an RCC <3cm

A

surgical ablation

32
Q

how would you manage an RCC >3cm

A

partial nephrectomy

33
Q

how would you manage a large RCC

A

radical nephrectomy - removal of whole kidney + surrounding fat

34
Q

what age group does testicular cancer commonly affect

A

men aged 20-45

35
Q

seminomatous testicular cancer is rare in what age group

A

before puberty - common 30-50

36
Q

what are risk cancers for testicular cancer

A

undescended testes (cryptorchidism), previous TC, HIV, FH

37
Q

Germ cell tumours are the most common type of TC, name 3 types of germ cell tumour

A

seminoma (55%), non-seminomatous, teratoma

38
Q

aside from germ cell tumours, what tumours can also be present in TC

A

leydig and sertoli cell tumours

39
Q

what is the most common presenting symptom of TC

A

a painless swelling/ nodule in one testicle that cannot be transilluminated +/- pain in abdomen (abdo mass = advanced disease)

40
Q

what are systemic symptoms of TC

A

weight loss, neck lumps, gynaecomastia, bone pain

41
Q

what investigations are done for TC

A

USS, CT, serum tumour markers, FBC

42
Q

what tumour markers are used in TC

A

AFP, bHCG, LDH

43
Q

what is the treatment of TC

A

1) radical inguinal orchiectomy 2) adjuvant chemo for non-seminomas and radio for seminomas

44
Q

name some types of penile cancer

A

SCC, kaposi’s sarcoma, BCC, melanoma, sarcoma

45
Q

what is the most common type of penile cancer

A

SCC (95%)

46
Q

what are risk factors for penile cancer

A

50-60, phimosis, pre-malignant conditions, HPV, smoking

47
Q

what is phimosis

A

foreskin is too tight and cannot be pulled back from foreskin

48
Q

where is the most common site for penile cancer

A

glands (tip) 50%

49
Q

what is a common presentation of penile cancer

A

hard, painless, red lump +/- smell, rarely urinary retention or mass

50
Q

what investigations are done for penile cancer

A

biopsy, MRI/ USS for invasion

My2 renal (27 decks)

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