Flashcards in Renal Carcinomas Deck (24):
MC primary renal malignancy
renal cell carcinoma
MC age and gender a/w renal cell carcinoma
6th-8th decade, ~64 avg
Risk factors for renal cell carcinoma
heavy aspirin, NSAIDS
MC type of renal cell carcinoma? What is the genetic mutation?
deletion of chromosome 3p
What are the usual sx of renal cell carcinoma?
usually asymptomatic until advanced disease
What is the usual diagnostic scan for renal cell carcinoma?
CT abd w/ & w/o contrast
What must be done w/ all solid renal masses and why?
even smaller masses may by malignant
In what type/stage of RCC is surgery curative?
localized RCC (stages I, II, III)
What is considered a small renal mass?
why is increasing size important?
< 4 cm
the larger the mass, the more likely it is high-grade or advanced RCC
What studies/management is indicated w/ a small renal mass?
-dedicated renal CT or MRI w/o and then w/ contrast
-CMP and BMP- paraneoplastic syndrome
-renal fxn to eval for CKD
-chest imaging for mets
When is surveillance an option with small renal masses?
if the mass is < 1 cm
MC type of renal tumor in children?
MC presentation of pt w/ Wilms tumor?
Abdominal mass= MC
What is the initial study done in pts done w/ possible Wilms tumor?
What is done for definitive dx?
initially= abd U/S
Definitive= histologic confirmation (surgical excision or biopsy)
What is tx for Wilms tumor? Prognosis?
chemo and surgical excision
good, 5-year survival 90%
What does renovascular disease cause?
What is gold standard for diagnosing renovascular diseases?
But... what is more commonly done?
Duplex Doppler US= gold standard
CTA = MC
What is the cause of atherosclerotic renal artery disease?
reduced blood flow to kidney
usually involves aortic orifice or proximal main renal artery
What are Risk factors for atherosclerotic renal artery stenosis?
-age > 50
What result is needed for dx of atherosclerotic renal artery stenosis?
how do you treat?
luminal occlusion of at least 60-75%
tx HTN, monitor CKD, revascularization
What age group/gender is most at risk for fibromuscular dysplasia?
women < 50 yo
What is fibromuscular dysplasia?
noninflammatory, nonatherosclerotic disorder leading to arterial stenosis, occlusion, aneurysm, dissection, and arterial tortuosity
What are clinical signs of fibromuscular dysplasia?
-HA, pulsatile tinnitus, neck pain, flank pain, abd pain
-HTN, cervical or abdominal bruit, TIA, stroke