37. Renal cell carcinoma Flashcards Preview

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Flashcards in 37. Renal cell carcinoma Deck (21):
1

MC primary renal cancer

Renal cell carcinoma

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Renal cell carcinoma originates from

PCT cells

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Renal cell carcinoma - histology

polygonal clear cells filled with accumulated lipids and carbohydrates

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gross apprerance

golden yellow due to high lipid content

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MC in

men 50-70 years old

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Risk factors

1. Smoking
2. Obesity
3. Gene deletion of chromosome 3 ( sporadic or inheritance as von Hippel - Lindau)

7

von Hippel -Lindau disease - manifestation

1. hemangioblastomas in retina, brain stem, cerebellum , spine
2. angiomatosis ( cavernous hemangiomas in skin , mucosa , organs
3. bilateral renal cell carcinoma
4. pheochromocytoma

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clinical manifestations

1. hematuria
2. palpable mass
3. polycethemia
4. flan pain
5. fever
6. weight loss

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metastasis

invade renal vein then IVC and spreads hematogenously ---> metastasizes to lung and bone

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paraneoplastic syndromes

1. EPO
2. ACTH
3. PTHrP
4. RENIN

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neoplasma that produce erythropoietin

1. renal cell carcinoma
2. hemangioblastoma
3. hepatocellular carcinoma
4. leiomyoma
5. pheochromocytoma

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neoplasms that procude ACTH ( cushing syndrome )

1.small cell carcinoma of the lung
2. renal cell carcinoma

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neoplasm that causes paraneoplastic hypercalcemia ( and why)

1. Hodgkin and 2.non- Hodgkin lymphoma (1.25-(OH)2D) calcitriol))
3. SCC of the lung
4. renal cell carcinoma
5. breast cancer

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prognosis (why?)

poor:
1. Resistan to chemotheraoy and radiation therapy
2. Silent cancer --> commonly presents as a metastatic neoplasm

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treatment?

1. resection if localized disease
2. immunotherapy ( aldesleukin, INF-α , Bevacizumab ) --> resistant to chemotherapy and radiation therapy

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renal cell carcinoma vs oncocytoma according to origin

renal cell ca--> PCT
oncocytoma --> collecting ducts

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• Renal cell carcinoma (RCC) is a malignancy of which cell type?

RCC develops from PCT cells, which become filled with lipids and carbohydrates

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• A hyperviscosity syndrome develops in a smoker with hematuria, weight loss, and a palpable flank mass. What is the likely cause?

Renal cell carcinoma producing excess EPO, leading to polycythemia

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• What is the mechanism of renal cell carcinoma metastasis?

It invades renal vein and IVC, then spreads hematogenously

20

• What is the chromosomal abnormality most often implicated in renal cell carcinoma?

A gene deletion on chromosome 3, either sporadic or inherited via von Hippel-Lindau syndrome

21

• To which two types of cancer treatment is renal cell carcinoma resistant?

Chemotherapy and radiotherapy

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