Renal Cell Cancer

Question 1

Renal cell cancer is also known as…?

Answer 1

hypernephroma and accounts

Question 2

RCC accounts for what percentage of Primary renal neoplasms?

Answer 2

85% of primary renal neoplasms

Question 3

From what cells does RCC arise?

Answer 3

proximal renal tubular epithelium

Question 4

Most common histological subtype of RCC?

Answer 4

clear cell (75 to 85%)

Question 5

Risk factors associated with RCC

Answer 5

• middle-aged men
• smoking
• von Hippel-Lindau syndrome
• tuberous sclerosis
• autosomal dominant polycystic kidney disease

Question 6

Classical triad of RCC

Answer 6

haematuria
loin pain
abdominal mass

Question 7

RCC’s may have endocrine effects. What can they secrete?

Answer 7

• erythropoietin (causing polycythaemia)
• parathyroid hormone-related protein (causing hypercalcaemia)
• renin
• ACTH

Question 8

What percentage of RCCs have metastasised at presentation?

Answer 8

25%

Question 9

how do RCCs cause varicoceles?

Answer 9

• caused by the tumour compressing veins
• hence why majority are left-sided

Question 10

Name the syndrome:
- Paraneoplastic disorder associated with RCC
- presents as cholestasis/ hepatosplenomegaly
- secondary to increased levels of IL-6

Answer 10

Stauffer syndrome

Question 11

What stage is the following RCC?

Tumour ≤ 7 cm and confined to the kidney

Answer 11

T1

Question 12

What stage is the following RCC?
Tumour > 7 cm and confined to the kidney

Answer 12

T2

Question 13

What stage is the following RCC?
Tumour extends into major veins or perinephric tissues, but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia

Answer 13

T3

Question 14

What stage is the following RCC?
Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland)

Answer 14

T4

Question 15

Management of RCC

Answer 15

• Surgery - partial or total nephrectomy
• alpha-interferon and IL-2
• Receptor tyrosine kinase inhibitors (e.g. sorafenib, sunitinib)