Tumours of Bladder & Kidneys Flashcards
From which cells does renal cell carcinoma occur?
Epithelial cells of the proximal convoluted tubules in the renal cortex.
What is the most common type of renal cell carcinoma?
What are some risk factors?
Clear cell renal cell carcinoma.
Risk factors:
- Obesity
- Smoking
- Hypertension
What is Von-Hippel Lindau disease?
Genetic disorder - mutation in VHL tumour suppressor gene.
Associated with renal cell carcinoma
Classic triad for renal cell carcinoma presenation.
- Haematuria
- Flank pain
- Palpable mass
What scrotal sign might be seen in RCC?
How?
Scrotal varices.
RCC can spread into the IVC from the left kidney, obstructing the left gonadal vein → varices.
How is RCC treated?
- Surgery
- Immunotherapies
RCC is very resistant to chemotherapy.
Describe metastatic spread of RCC
RCC → Renal vein → IVC → lung, bone, brain
Why does RCC have a low survival rate?
Often silent until late stages, and it is resistant to chemotherapy.
What are the two types of bladder tumours, and whch is more common?
- Urothelial carcinoma (90%)
- Squamous cell carcinoma
How are urothelial carcinomas classified?
Based on spread
- Superficial
- Muscle-invasive
- Metastatic
Risk factors for bladder cancer?
- Smoking
- Old age
- Occupational carcinogen exposure - chemical, dye, rubber industries.
What are the two pathways of urothelial carcinoma?
P53 dependent - aggressive, P53 mutations
P53 independent - low grade, less aggressive.
Hallmark symptom of bladder cancer?
Painless haematuria.
Diagnosis of bladder cancer
-
- Urine cytology
- Cytoscopy
- Biopsy
- Imaging
Treatment of different stages of urothelial carcinoma?
Superficial / non-muscle-invasive = resection + chemo
Muscle invasive = cystectomy + radiation/chemo
