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Renal cell carcinoma
Terms in this set (17)
Define renal cell carcinoma
Most common solid renal tumor (90%); originates from proximal renal tubular epithelium
What is the epidemiology?
Primarily a tumor of adults 40 to 60 years of age with a 3:1 male:female ratio; 5% of cancers overall in adults
What percentage of the tumors are bilateral?
What are the risk factors?
Male sex, tobacco, von Hippel-Lindau syndrome, polycystic kidney
What are the symptoms?
Pain (40%), hematuria (35%), weight loss (35%), flank mass (25%), HTN (20%)
What is the classic TRIAD of renal cell carcinoma?
1. Flank pain
3. Palpable mass
(triad occurs in only 10%-15% of cases)
How are most cases diagnosed these days?
Found incidentally on an imaging study (CT, MRI, U/S) for another reason
What radiologic tests are performed?
2. Abdominal CT scan with contrast
Define the stages (AJCC):
Stage I: Tumor 2.5 cm, no nodes, no metastases Stage II: Tumor 2.5 cm limited to kidney, no nodes, no metastases
Stage III: Tumor extends into IVC or main renal vein; positive regional lymph nodes but 2 cm in diameter and no metastases
Stage IV: Distant metastasis or positive lymph node 2 cm in diameter, or tumor extends past Gerota's fascia
What is the metastatic workup?
CXR, IVP, CT scan, LFTs, calcium
What are the sites of metastases?
Lung, liver, brain, bone; tumor thrombus entering renal vein or IVC is not uncommon
What is the unique route of spread?
Tumor thrombus into IVC lumen
What is the treatment of RCC?
Radical nephrectomy (excision of the kidney and adrenal, including Gerota's fascia) for stages I through IV
What gland is removed with a radical nephrectomy?
What is the unique treatment for metastatic spread?
1. Alpha interferon
2. LAK cells (lymphokine-activated killer) and IL-2 (interleukin-2)
What is a syndrome of RCC and liver disease?
What is the concern in an adult with new onset left varicocele?
Left RCC—the left gonadal vein drains into the left renal vein
THIS SET IS OFTEN IN FOLDERS WITH...
Lipid disorders (PEARLS)
Pleural Diseases (PEARLS)
OTHER SETS BY THIS CREATOR
Neoplastic Diseases of the Renal System (PEARLS)
Chronic Kidney Disease
Acid Base Disorders (PEARLS)