Kidney & Ureter tumors and infection Flashcards
(21 cards)
Most common primary malignant neoplasm of kidney?
Renal cell carcinoma or Grawitz tumor
Most common site of origin of RCC is?
Proximal convoluted tubules
Risk factors for RCC?
Tobacco exposure(most significant)
Obesity
Hypertension
- Analgesics: inc risk for RCC
- Lead compounds
- Various chemicals(eg: aromatic hydrocarbons)
- Trichloroethylene exposure
- Occupational exposure(chemical, rubber and printing industries)
- Asbestos or cadmiun exposure
- Radiation therapy
subtypes of RCC?
- Clear cell
- Papillary
- Chromophobic
- Collecting duct
Cell of origin of following: 1 Clear cell 2 Papillary 3 Chromophobic 4 Collecting duct
- Proximal tubule
- Proximal tubule
- Cortical collecting duct
- Medullary collecting duct
most common subtype of RCC?
Clear Cell Carcinoma
most common subtype of RCC in dialysis associated cystic disease?
Papillary carcinoma
Subtype associated with sickle cell trait?
Renal medullary cell carcinoma
subtype with best diagnosis?
Chromophobe carcinoma
subtype which tend to be bilateral?
Papillary
classical triad of RCC?
- Hematuria
- Flank pain
- Palpable flank mass
characteristic feature of RCC regarding spread/invasion/metastasis?
Tendency to invade Renal vein. further extension extends into IVC and even right side of heart
MC site of distant metastasis is?
Lung(xray shows canon ball secondaries)
Investigation of choice for RCC?
Contrast enhanced CT scan
what are the primary indications for needle aspiration or biopsy of renal mass?
They are:
- when a renal abscess or infected cyst is suspected and when
- RCC must be differentiated from metastatic malignant disease or renal lymphoma
treatment of choice for RCC?
Radical nephrectomy
chemotherapy and radiotherapy is not effective
major clinical manifestations in von Hippel-Lindau syndrome?
- Clear cell RCC
- Hemangioblastomas of CNS
- Retinal angiomas
- Pheochromocytoma
major clinical manifestations in Birt- Hogg-Dube syndrome?
- Chromophobe RCC
- Oncocytoma
- Occasional clear cell RCC
- Cutaneous fibrofolliculomas
- Lung cysts
- Spontaneous pneumothorax
what is partial nephrectomy(Nephron sparing surgery)?
partial nephrectomy is preferred surgical approach for a small(<4cm) localized tumor; especially in patients with functionally and anatomically solitary kidney
partial nephrectomy should be considered in which clinical situations?
- Renal mass less than 4cm(T1 stage)
- Localized mass in patient with single kidney or with compromised renal function
- Synchronous bilateral renal tumors
- Patients with VHL syndrome as they are at high risk of renal cancer in contralateral kidney
MC carcinomas of renal pelvis and ureter?
- Transitional cell carcinoma(MC, 90-97%)
- Squamous cell carcinoma
- Adenocarcinoma
