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Y2 Renal > Tumours of the kidney > Flashcards

Tumours of the kidney Flashcards

1
Q

Most common type of renal cell cancer

A

Renal Cell Carcinoma

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2
Q

What is renal cell carcinoma

A

Adenocarcinoma of the renal cortex

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3
Q

Where did renal cell carcinoma arise from

A

proximal convoluted tubule

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4
Q

Risk factors of renal cell carcinoma

A

Smoking
Renal failure and dialysis
Obesity
Hypertension
Asbestos exposure
Genetics - Von Hippel Lindau syndrome

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5
Q

Renal cell carcinoma most commonly affect males / females

A

Males

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6
Q

What score is used to differentiate between RCC and polycystic kidney disease and why is this score needed

A

Bosniak score, because some RCC can have a cystic component

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7
Q

How does RCC usually spread

A

haematogenous spread

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8
Q

Where does RCC usually spread to

A

adrenal gland (direct invasion)
lungs
bone
brain

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9
Q

Symptoms of RCC

A

Haematuria
loin pain
mass
Varicocoele - enlargement of the veins within the loose bag of skin that holds the testicles
Hypertension
Hypercalcaemia
Polycythemia

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10
Q

What is polycythemia and how does RCC cause polycythemia

A

high concentration of red blood cells

Due to increase in production of erythropoietin

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11
Q

How does RCC cause hypercalcamia

A

PTHrPproduced by the tumour

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12
Q

Investigations for RCC

A

CT kidneys
CT abdomen, chest to look for metastases
Bloods

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13
Q

When is biopsy used in RCC

A

Before ablative therapies if nephrectomy is not planned

Biopsy is not routinely performed to look for RCC because most renal tumours are malignant

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14
Q

Management of RCC

A

T1 - partial nephrectomy
T2 and above - radical nephrectomy

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15
Q

Why is surgery the main treatment in RCC

A

Because RCC is relatively insensitive to chemotherapy and radiotherapy

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16
Q

What is transitional cell carcinoma

A

Rare malignancy of the transitional cells that line the renal pelvis

17
Q

Which parts of the renal system are lined by transitional cells

A

renal pelvis, ureters, bladder and urethra

18
Q

Transitional cell carcinoma mostly affects which part of the renal system

A

Mostly causes lower urinary tract malignancy instead of renal malignancy

19
Q

Which gender is most commonly affected by transitional cell carcinoma

A

Males

20
Q

Management of transitional cell carcinoma

A

radical nephroureterectomy (also removes the ureters)
Chemotherapy for partial resection of kidneys / palliative care

21
Q

Which age group is most commonly affected by nephroblastoma (Wilm’s tumour)

A

Children under 15

22
Q

Symptoms of nephroblastoma (Wilm’s tumour)

A
  • Painless, palpable abdominal mass
  • Loss of appetite
  • Abdominal pain
  • Fever
  • Nausea and vomiting
  • Haematuria
23
Q

Investigations for Wilm’s tumour

A

US
CT

24
Q

Management of Wilm’s tumour

A

Surgical resection combined with chemotherapy

25
Q

What are the benign renal tumours

A

Oncocytoma
Angiomyolipoma

26
Q

What is oncocytoma

A

Benign tumour made of oncocytes - cells with excess amount of mitochondria

27
Q

Presentation of oncocytoma

A

Mostly asymptomatic, found incidentally
Loin pain
Haematuria

28
Q

Investigations for oncocytoma

A

CT
Biopsy

29
Q

Management for oncocytoma

A

Observation

30
Q

Angiomyolipoma is a benign lesion consisting of

A

Blood vessels, immature smooth muscle, and fat

31
Q

Most common aetiology of angiomyolipoma

A

80% sporadic
20% present with tuberous sclerosis

32
Q

Symptoms of angiomyolipoma

A

May be asymptomatic, discovered incidentally
Loin pain
Haematuria
Mass
Wunderlich’s syndrome

33
Q

What is Wunderlich’s syndrome

A

spontaneous, nontraumatic renal hemorrhage into perirenal space (behind the peritoneum)

34
Q

What is the classic triad of symptoms for Wunderlich’s syndrome

A

acute loin pain
loin mass
hypovolemic shock

35
Q

Investigations for angiomyolipoma

A

US
CT

36
Q

Management of angiomyolipoma

A

> 4cm lesions usually cause symptoms so will require surgical resection

Y2 Renal (12 decks)

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