Week 4 - E - Urological malignancies - RCC, benign & penis cancers Flashcards

1
Q

What is the most common type of kidney cancer?

A

Renal cell carcinoma

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2
Q

Is renal cell carcinoma an adneo or squamous carcinoma?

A

It is an adenocarcinoma

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3
Q

What is a classic triad of features in renal cell carcinoma?

A

Haemeturia, flank pain and abdominal mass

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4
Q

Ultrasoun can be used to differentiate the tumour from what?

A

Cyst vs solid tumour

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5
Q

Vast majority of kidney lesions are benign as they are asymptomatic simple cysts – can have single or multiple benign cytss What is used for these?

A

Ultrasound or Contrast Ct - nephrographic phase shows cysts

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6
Q

Benign Blood vessels, fat, muscle What i this tumour known as?

A

Angiomyolipoma

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7
Q

What is used for diagnosis of an angiomyolipoma? Why can embolisms form from them?

A

Use a CT scan

They can haemorrhage and therefore bleed and then clot causing an embolism

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8
Q

Haemorrhage of the angiomyolipoma can occur that is confined to the perirenal space What is this syndrome known as?

A

This is known as Wunderlich’s syndrome -

Wunderlich syndrome is spontaneous, nontraumatic renal hemorrhage confined to the subcapsular and perirenal space.

It may be the first manifestation of a renal angiomyolipoma (AML)

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9
Q

What two cancers are aossicated with a cannonball metastases to the lungs?

A

Renal cell carcinoma and choriocarcinoma (testicular tumour)

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10
Q

How does a renal cell carcinoma present? (5 symptoms/signs at least)

A

Hameaturia

Flank pain

Abdominal mass

Weight loss

Anaemia

Hypertension

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11
Q

Renal cell carcinoma usually presents at ages 65-75 years What do you suspect if multifocal or bilateral renal cell carcinoma of a young patient?

A

VHL - von hiipel lindau syndrome -

hemangioblastomas, pheochromocytoma, renal cell carcinoma, pancreatic cysts – VHL gene mutation causing VHL

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12
Q

Why may a renal cell carcinoma present with a varicocele if it has invaded the renal vein?

A

This is because the spermatic vein cannot drain into the left renal vein therefore the veins on the testis become swollen and dilated

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13
Q

In renal cell carcinoma. what is used as diagnosis?

A

Ultrasound followed by a CT scan

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14
Q

Why are biopsies not very good at diagnosing renal cell carcinomas?

A

They have a high false negative

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15
Q

What type of CT scan is used in renal cell carcinoma?

A

Triple phase CT scan

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16
Q

What is the name for the staging of renal cell carcinomas?

A

Robson staging

17
Q

Staging for renal cell carcinoma is done via robson staging What are the 4 common metastases?

A

Lung Liver Bone Brain

18
Q

Stage 1 of the robson staging of renal cell carcinomas is confined with in the capsule What is stage 2?Term

A

tumour has spread to perinephric fat but has not invaded Gerota’s fascia (deep renal fascia)

19
Q

At what robsons stage, does the RCC invade the renal vein?

A

Robson stage 3

20
Q

What tumour stage is radical nephrectomy carried out?

A

Tumour stages 1 or 2

21
Q

When a patient has metastatic disease, what is the measurement of performance status that is used before deciding on treatment?

A

The ECOG Scale of Performance Status is one such measurement.

22
Q

What are potential drugs given for metastatic disease?

A

IL2 - interleukin 2

Interferon alpha tyrosine kinase inhibitors (sutinib)

23
Q

What is stage 1 and stage 4 five year survival rate?

A

Stae 1 - 75% Stage 2- 50% Stage 3 - 35% Stage 4 - 5%

24
Q

What is a bad prognostic sign for RCC?

A

Inasion into the renal vein

25
Q

What are premalignant cutaneous lesions on the penis?

A

Bilantis xerotica obliterans and leukoplakia

Squamous cell carcinoma in situ - erythroplasia of queryat

26
Q

Squamous cell carcinoma (of the penis)  Malignant proliferation of squamous cells of penile skin  Not common 

Risk factors - what are the two main ones?

A

HPV type 16

Lack of circumcision - foreskin can act as a site of inflammation if not properly cleaned

27
Q

If the squamous cell carcinoma in situ is on the prepuce alone, what is the treatment? If on other parts what drug is given?

A

Circumscion alone if confined to prepuce

5-fluorouracil

28
Q

In a primary penil tumour , what investigation is carried out to check for corpus cavernosum invasion?

A

Ultrasound

29
Q

What is the treatment for penis cancer?

A

Total or partial penectomy and radiotherapy if metastasised

30
Q

What age does someone get a seminoma usually? What age for a teratoma?

A

Seminoma - usally 30-50s - measure placental alkaline phosphatase (PLAP)

Teratoma - usually 20-50s – 100% elevated HCG if trophoblastic, can measure alfafetoprotein (AFP) if yolk sac components