renal tumors Flashcards
hematuria nephritic wala nephrotic
nephritic
which type of renal cell carcinoma is the most aggressive ?
medullary carcinoma
which RCC is associated with ESRD ?
papillary RCC
what is the most common type of renal cell carcinoma ?
clear cell (conventional) , associated with alteration in 3p
what grading system is used for clear cell RCC ?
fuhrman’s system
what is the clinical manifestation of hereditary papillary RCC ?
type 1 papillary RCC
what is the clinical manifestation of hereditary leiomyoma RCC ?
type II papillary RCC
what is the TNM staging in RCC ?
T1- confined to the kidney and is less than 7 cm
T2 - confined to thee kidney and more than 7 cm
T3a - locally advanced into renal vein adrenal or perirenal fat
T3b- IVC below diaphragm
T3c- IVC above diaphragm
T4- beyond gerota
what are the paraneoplastic syndromes associated with RCC ?
HTN
hypercalcemia
polycythemia or anemia
non-met hepatic dysfunction (stauffer syndrome)
what is stauffer syndrome ?
a paraneoplastic disorder associated with RCC , hepatic dysfunction without metastasis
when do we use MRI in renal investigations ?
if there is any suspected venous involvement
what is the management of RCC ?
surgery is the mainstay of treatment
what is the treatment of localized disease ?
T1and T2
radical nephrectomy
nephron sparing surgery
what are the alternatives to surgery in RCC ?
ablation ( radiofrequency/ cryoablation)
when is ablation indicated ?
1- for patients with significant comorbidities and small lesions which are
2- below 4 cm
3- peripheral
4- solid exophytic lesions
when is active surveillance indicated ?
elderly patients with significant comorbidities and small lesions ( which is less than 3 cm) with a slow growth rate
what is the management of T3 tumors ?
surgical resection with vascular control
is chemotherapy indicated in RCC ?
RCC is a chemoresistant tumor
what is the management of metastatic disease ?
systemic therapy - immunological therapy , targeted therapy. with tyrosine kinase inhibitor
surgical resection : cytoreductive nephrectomy , metastatectomy
what are the differential diagnosis for RCC ?
AML - Angiomyolipomas
Oncocytoma
what is the hereditary association with upper tract TCC ?
lynch syndrome
what type of nephropathy is associated with upper tract TCC ?
balkan nephropathy
what is the genetic inheritance associated with upper tract tcc ?
autosomal dominant
what are the differential diagnosis of filling defect in upper tract TCC ?
radiolucent stone
clot
fungus ball
TB
