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The Renal System > Urological Malignancy > Flashcards

Urological Malignancy Flashcards

1
Q

How can benign renal cysts be imaged?

A

USS

(maybe contrast CT)

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2
Q

Which symptoms are caused by benign renal cysts?

A

Generally no symptoms

(very common incidence 1:10)

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3
Q

What is an angiomyolipoma?

A

A benign process involving a disproportionate amount of blood vessels, fat and muscle

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4
Q

How can an angiomyolipoma be imaged?

A

CT

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5
Q

What is the main risk of angiomyolipoma?

A

Haemorrhage and sudden cardiovascular collapse

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6
Q

How is angiomyolipoma treated?

A

Embolisation if large

(prevents bursting and blood loss)

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7
Q

What is an oncocytoma?

A

A benign renal tumour

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8
Q

What is the characteristic appearance of an oncocytoma?

A

Central scar on CT

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9
Q

Why does an oncocytoma develop a central scar?

A

Not malignant so does not possess angiogenic potential

Centre necroses and scars

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10
Q

How can oncocytoma be diagnosed?

A

Only at total nephrectomy

Biopy or 99m-Tc-Sestamibi SPECT-CT can indicate

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11
Q

What is the classic triad of symptoms for a renal tumour?

A
  1. Loin pain
  2. Renal mass
  3. Haematuria

Vast majority are picked up incidentally before the classic triad appears

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12
Q

What are the main paraneoplastic symptoms of renal cell carcinoma?

A

Weight loss

Anaemia

Hypercalcaemia (produces parathyroid like peptide)

Hypertension

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13
Q

What is the peak incidence for renal cell carcinoma?

A

65-75

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14
Q

What is a renal cell carcinoma?

A

Adenocarcinoma of proximal convoluted tubule

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15
Q

In patient who has multifocal renal cell carcinoma or bilateral tumour, what may be the cause?

A

Von hippel-Lindau

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16
Q

How can renal cell carcinoma be diagnosed?

A

USS

Triple phase CT

Percutaneous biopsy

Nephrectomy

17
Q

Renal cell carcinomas are contrast ___________

A

Renal cell carcinomas are contrast enhancing

18
Q

What is the staging system used for rena cell carcinoma?

A

Robson staging

(or TNM)

19
Q

Where do renal cell carcinomas commonly metastasize?

A

Lungs (most common)

Liver

Bone

Brain

20
Q

What is the standard surgery for renal cell carcinoma?

A

Laparoscopic nephrectomy

21
Q

What is not removed routinely in a laparoscopic nephrectomy?

A

Adrenal gland(s)

22
Q

What is the idea behind partial nephrectomy?

A

Nephron sparing

Prevents unnecessary drop in GFR

23
Q

In patients with small masses, or those where the kidneys cannot be removed, what treatment options are there for renal cell carcinoma?

A

Radiofrequency ablation

Cryotherapy

24
Q

How are small renal masses diagnosed?

A

Almost always by incidental imaging

25
Q

How are small renal masses generally treated?

A

Biopsy first

Benign - Monitor

Malignant:

  1. Minimally invasive ablation
  2. Partial nephrectomy
26
Q

What do tyrosine kinase inhibitors do for renal cell carcinomas?

A

Inhibit angiogenesis pathway

27
Q

What precancerous lesion on the foreskin has white oatches, fissuring, bleeding and scarring

A

Balantitis xerotica obliterans

28
Q

What should be done for BXO?

A

Circumcision

(unless spread further)

29
Q

Carcinoma of the penis is related to which virus?

A

HPV (type 16)

30
Q

Where does carcinoma of the penis spread?

A

Inguinal nodes

31
Q

What are the treatment options for penile carcinoma?

A

Surgery

Radiotherapy and chemotherapy

Inguinal lymphadenopathy (prevents potential for spread)

32
Q

What are the most common germ cell tumours of the testes?

A

Seminoma

Non-seminomatous

33
Q

How do testicular tumours present?

A

Painless swelling

34
Q

Which imaging test is the gold standard for testicular tumours?

A

USS

(Staging for CT, CXR in case of metastasis)

35
Q

What are the different markers for testicular cancer?

A

AFP

HCG

LDH

36
Q

In pure seminoma, which marker is never raised?

A

AFP

37
Q

*What are the types of non-seminomatous testicular cancers?

A
38
Q

Where can testicular cancers spread?

A

Lumbar nodes

39
Q
A

The Renal System (37 decks)

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