Renal cancer

Question 1

Common types of renal cell carcinoma

Answer 1

1. Clear cell renal cancer (most common type) - cause range of parneoplastic manifestations
2. Papilary renal cancer type 1 and 2.

Question 2

What imaging used for staging

Answer 2

Contrast-enchanced CT chest, abdo, pelvis

Question 3

Symptoms - triad

Answer 3

1. Flank pain
2. Haematuria
3. Palpable abdominal mass.

Question 4

Other clinical signs

Answer 4

Scrotal varicocele
Lower limb oedema
Cervical lymphadenopathy

Question 5

Risk factors

Answer 5

Cig smoking
Obesity
HTN
Haemodialysis

Question 6

Gennetic manifestation of clear and papillary rcc

Answer 6

Von Hippel linadu syndrome - VHL3 - clear cell rcc

Heditary papillary - c MET - type 1 pap rcc
Familal leimymatosis - Fumarate hydratase 1 - type2 pap rcc

Question 7

Management of rcc

Answer 7

stage 1 - partial nephrectomy
Stage2 - radical nephrectomy
stage 3 - !! - and lymph node diseection + immunotherapy before surgery
Metastic -> systemic therapy inv immunotherapy.

Question 8

immediate complications

Answer 8

Tumour embolus, Pneumothorax, injury t surrounding organs

Question 9

Early complications

Answer 9

DVT/PE/MI
Chest infections
Post Op bleed
Wound infection

Question 10

Blood investigations

Answer 10

Normal + LDH, calcium, LFT

Question 11

What are the indications that patient has Stage IV RCC

Answer 11

Symptomatic patients + symptom of spread (e.g dry cough- lungs)
Tyrosine kinase inhibitors + immunotherapy

Question 12

If high sus of bladder cancer, does cystocopy but came normal. What ix next to do?

Answer 12

Renal tract ultrasound.
Required under 2WW refferal.
Sus of renal tract cancer