Flashcards in Clinical (Week 4) Deck (274)
What is a hamartoma?
A tumour with the correct constituencies of the organ it's from but in wrong distribution
What is the most common renal pelvis tumour?
Transitional cell carcinoma
What is the most common renal parenchymal tumour?
Renal cell carcinoma
What is the most common renal embryonic tumour?
Nephroblastoma (Wilm's Tumour)
What sort of CT is useful in diagnosing a urological malignancy?
Triple phased contrast enhanced
What is the most common benign asymptomatic renal lesion?
Renal cyst (70%)
How do we investigate renal cysts and why can we use this modality?
USS (it is fluid-filled)
When would we biopsy an angiolypoma?
- Risk of bled
What feature of vessels in an angiolypoma make it prone to bleeds?
They are fragile
How can we measure lesion density on a CT of angiolypomas?
What is Wunderlich's Syndrome?
Collapse due to retroperitoneal bleed in an angiolypoma
How does an oncocytoma appear on CT?
- Stellate due to central necrosis
-> No angiogenesis therefore benign
What is the only way to definitively diagnose an oncocytoma and why is a biopsy not totally useful?
Biopsy has a high false negative rate
What is the classic triad of symptoms in a renal cell carcinoma?
Loin pain (40%)
Renal masses (25%)
Frank haematuria (60%)
Which of the following is not a paraneoplastic effect of renal cell carcinoma:
- Weight loss
- Hypercalcaemia (As it produces parathyroid-like hormone)
What is the M:F ratio for the incidence of a renal cell carcinoma?
What is the peak incidence age for renal cell carcinoma?
What type of cancer of a renal cell carcinoma and where is it found?
How do renal cell cancers appear histologically?
If there are bilateral or multifocal renal cell carcinomas, what condition should you suspect and what implications does this have?
- Implications for surgery
What is the first line investigation for renal cell carcinoma, and what is the best investigation?
1st line - USS
- Triple phase contrast CT
What is the downside to using biopsy in the diagnosis of renal cell carcinomas?
High false negative rate
What staging system is used for renal cell carcinomas?
True or false; Direct perinephric fat invasion is rare in renal cell carcinomas?
How do renal cell carcinomas tend to spread?
Where do renal cell carcinomas commonly spread?
Lungs ('Cannon ball' metastases)
What is the standard treatment for a renal cell carcinoma? What does the treatment involve?
Radical nephrectomy (preferably laparoscopically):
- Whole kidney within Gerota's fascia
- Perinephric fat removed
When is the standard treatment for a renal cell carcinoma most often carried out?
Within a month of diagnosis
When would the adrenal gland be removed in the treatment of renal cell carcinoma and why is it not routinely removed?
If it is involved
Reduces the risk of adrenal insufficiency (Addison's syndrome)