Renal Tumours

Question 1

What score is used to predict cancer?

Answer 1

Bosniak score

Question 2

What is the name of the infection that can mimic malignancy in the kidneys?

Answer 2

Xanthogranulomatous pyelonephritis

Question 3

Match the following to the tumour type:
Benign
Malignant

Papillary
Clear cell
Collecting duct 
Oncocytoma
Chromophobe
Angiomyolipoma

Answer 3

Benign

• oncocytoma
• angiomyolipoma (most common)

Malignant (all types of renal cell carcinoma)

• clear cell
• papillary
• collecting duct
• chromophobe

Question 4

What is the name of the tumour that is found in kids?

How would it present?

Answer 4

Wilm’s tumour

Often with an abdo mass - should always be in ur DD for kids abdo mass

Question 5

Mahogany brown tumour with a central stellate star?

Answer 5

Oncocytoma

Also has very pink and granular cytoplasm (oncocytic)

Question 6

What malignant tumour looks v similar to oncocytoma?

How can you tell the difference?

Answer 6

Chromophobe

Raisonid nuclei with perinuclear haloes (crinkly nuclei)

Question 7

What is the least common type of malignant?

it has a very bad survival rate

Answer 7

Collecting duct

Question 8

What is the most common type of renal cancer?

What is the biggest risk factor?

Answer 8

Clear cell carcinoma

Obesity (specifically waist circumference)

Question 9

How does clear cell carcinoma appear on histology?

Answer 9

Very bright yellow tumour surface

Question 10

Clear cell carcinoma can travel up through the renal vein and potentially into what vessel?

Answer 10

IVC

Question 11

Loss of what gene is assoc. with clear cell carcinoma?

Answer 11

VHL on chromosome 3

Question 12

What appears as spoke wheel pattern on CT?

Answer 12

Oncocytoma

Question 13

What are ‘cannonball mets’?

Answer 13

!! Common exam question !!

Mets from renal cell carcinoma that present in the lungs

Question 14

How is renal cell carcinoma managed?

Answer 14

<3cm - ablation therapy
>3cm - partial nephrectomy
LARGE - radial nephrectomy

Question 15

Explain these two paraneoplastic syndromes you can get with RCC:

• polycythaemia
• hypercalcaemia

Answer 15

Polycythaemia - increase in RBC due to RCC releasing uncontrolled erythropoietin

Hypercalcaemia - RCC can release a molecule that mimics PTH

Question 16

What is Stauffer’s syndrome?

Why does it occur?

Answer 16

Abnormal LFTS
Fever
Anaemia

Unknown cause

Question 17

What is the first line investigation for renal cancer?

If cancer is found what is the next investigation?

Answer 17

USS

CT chest abdo and pelvis

Question 18

Acquired cysts are common in kidneys. T/F?

Answer 18

T

Question 19

What is the triad of symptoms for renal cell carcinoma?

Answer 19

Loin pain
Haematuria
Palpable mass

Question 20

Angiomyolipoma is the most common benign tumour in the kidney.
What genetic condition is it associated with?
What complications can it cause that would present symptomatically?

Answer 20

Tuberous sclerosis
Burst and bleed
Get too big and impairs kidney function