Renal carcinoma

Question 1

Explain the pathology of renal carcinoma

Answer 1

Renal cell carcinoma is the most common renal tumours in adults
• Arise from the proximal tubular epithelium
• May be solitary, multiple and occasionally bilateral
• Renal cell carcinoma histological classifications:
• Clear cell
• Papillary
• Chromophobic
• Oncocytic
• Collecting duct

Question 2

What are the risk factors/aetiology of renal cancer?

Answer 2

• Male
• Age of presentation around 55 years old
• Obesity
• Smoking
• Radiation

Question 3

What are the signs/symptoms of renal cancer?

Answer 3

• Haematuria
• Loin pain
• Mass in the flank
• Malaise
• Weight loss
• Fever
• Left sided scrotal varicoceles – if renal tumour obstructs the gonadal vein
• Anaemia
• Polycythaemia
• Hypercalcaemia

Question 4

What investigations are conducted for suspected renal cancer?

Answer 4

• Ultrasonography – distinguish from cyst/tumour

* CT/MRI – involvement of vein/staging

Question 5

What are the surgical treatments for renal cancer?

Answer 5

• Radical nephrectomy
• Partial nephrectomy
• Cryoablation
• Radiofrequency ablation

Question 6

What are the pharmacological treatments for renal cancer?

Answer 6

• Interlukin 2 – advanced/metastatic disease
• Interferon – advanced/metastatic disease
• Vascular endothelial growth factor inhibitors e.g. sunitinib