Urological Malignancy

Question 1

how does renal cell carcinoma present?

Answer 1

—Classic Triad only in 15%
—Loin pain 40%
—Renal mass 25%
—Haematuria 60%

—Incidental on imaging

—Paraneoplastic syndromes
—Weight loss, anaemia, HT, hypercalcaemia

Question 2

Diagnosis of RCC

Answer 2

—USS

—CT- —Triple phase contrast
—

Biopsy
—High false negative in RCC
—

Question 3

describe robson staging of RCC

Answer 3

Question 4

where are common sites for RCC to metastisise to

Answer 4

—Lungs
—Liver
—Bone
—Brain

Question 5

what is the treatment for RCC?

Answer 5

—Radical Nephrectomy (inc. laparoscopic)
—Whole kidney within Gerota’s fascia
—Perinephric fat
—
—Partial Nephrectomy (nephron sparing)
—Open
—Robotis laparoscopy
—
—Radiofrequency ablation, cryoablation

Question 6

what is the 5 year survival for RCC?

Answer 6

—Stage 1 75%
—Stage 2 50%
—Stage 3 35%
—Stage 4 5%

Question 7

what is the presentation and managenment of balanitis xerotica obliterans?

Answer 7

sclerosis of prepuce, glans, and urethral meatus

management

circumcision, dilatation of meatus, and resurfacing of glans

Question 8

what are the different terms for carcinoma in situ and how is it treated?

Answer 8

—Erythroplasia of Queyrat
—Glans, prepuce or shaft of penis

Bowen’s disease
—Remainder of genitalia

—if prepuce alone- circumcision

—Topical 5 fluorouracil

Question 9

How does carcinoma of the penis present?

Answer 9

—Red raised area penis
—Fungating mass, foul smelling
—Phimosis

Question 10

describe the staging of carcinoma of the penis

Answer 10

stage 1: <2cm

stage 2: between 2 and 5 cm

Stage 3: >5cm or infitration of urethra

Stage 4: metastasized

Question 11

list the different types of germ cell tumours of the testes

Answer 11

—Seminoma

—Non-seminomatous germ cell tumour
—Teratoma, embryonal, yolk sac, choriocarcinoma
—

Intra-tubular germ cell neoplasia (ITGCN)

Question 12

what are the markers used to assess/ monitor/ stage tsticular tumours?

Answer 12

—AFP
—Never raised in pure seminoma
—
—HCG
—5-10% pure seminoma
—Up to 60% teratoma
—
—LDH
—Tumour burden