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
What are premalignant cutaneous lesions on the penis?
Bilantis xerotica obliterans and leukoplakia Squamous cell carcinoma in situ - erythroplasia of queryat
26
Squamous cell carcinoma (of the penis)  Malignant proliferation of squamous cells of penile skin  Not common  Risk factors - what are the two main ones?
HPV type 16 Lack of circumcision - foreskin can act as a site of inflammation if not properly cleaned
27
If the squamous cell carcinoma in situ is on the prepuce alone, what is the treatment? If on other parts what drug is given?
Circumscion alone if confined to prepuce 5-fluorouracil
28
In a primary penil tumour , what investigation is carried out to check for corpus cavernosum invasion?
Ultrasound
29
What is the treatment for penis cancer?
Total or partial penectomy and radiotherapy if metastasised
30
What age does someone get a seminoma usually? What age for a teratoma?
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