Renal tumours Flashcards
Types of renal tumour
Renal Cell Carcinoma
Transitional Cell Carcinoma
Risk factors for renal cell carcinomas
> 55 yrs M Obesity Smoking HTN Dialysis
Pathology of renal cell carcinoma
Adenocarcinoma from proximal renal tubular epithelium
Presentation of renal cell carcinoma
50% incidental finding
Triad:
- Haematuria
- Loin pain
- Loin mass
Varicocele - invasion of L renal vein
Paraneoplastic features of renal cell carcinoma
EPO - polycythaemia PTHrP - hypercalcaemia Renin - HTN ACTH - cushing's Amyloidosis
PTHrP
Parathyroid related protein
Secreted by some cancers
Metastasis sites of renal cell carcinoma
Bone
Liver
Lung
Ix for renal cell carcinoma
Polycythaemia Hypercalcaemia Urine cytology CXR - lung cannonball mets US - mass IVU - filling defect CT/MRI
IVU
Intravenous urogram
Robson staging of renal cell carcinoma
- Confined to kidney
- Involves perinephric fat, but not Garota’s fascia
- Spread into renal vein
- Spread to adjacent / distant organs
Medical Mx of renal cell carcinoma
Reserved for pts with poor prognosis
Temsirolimus - mTOR inhibitor
Surgical Mx of renal cell carcinoma
Radical nephrectomy
Partial nephrectomy
Risk factors for transitional cell carcinomas
> 50 yrs M Smoking Amine exposure (rubber industry) Cyclophosphamide
Locations for transitional cell carcinomas
Bladder
Ureter
Renal pelvis
Presentation of transitional cell carcinoma
Painless haematuria
Frequency, urgency, dysuria
Urinary tract obstruction
Ix for transitional cell carcinoma
Urine cytology
CT/MRI
IVU - pelviceal filling defect
Mx of transitional cell carcinoma
Nephrouretectomy
Association of Squamous Cell Carcinoma
Chronic infected staghorn calculi
Schistosomiasis
