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    Renal Cell Carcinoma

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    'asyura Mohd Reza
    1) Renal cell carcinoma arises from renal tubular cells and is the most common neoplasm of the kidneys. 2) It typically presents as a yellowish or dull white semi-transparent mass with areas of hemorrhage on the cut surface and can spread locally to the renal vein or distantly to bones and lungs. 3) Investigations include blood tests, imaging like ultrasound and CT scan to determine staging according to TNM classification, while treatment involves nephrectomy, with partial or complete removal of the kidney and ureter.

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    Renal Cell Carcinoma

    Uploaded by

    'asyura Mohd Reza
    204 views10 pages
    1) Renal cell carcinoma arises from renal tubular cells and is the most common neoplasm of the kidneys. 2) It typically presents as a yellowish or dull white semi-transparent mass with areas of hemorrhage on the cut surface and can spread locally to the renal vein or distantly to bones and lungs. 3) Investigations include blood tests, imaging like ultrasound and CT scan to determine staging according to TNM classification, while treatment involves nephrectomy, with partial or complete removal of the kidney and ureter.

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    renal cell carcinoma

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    1) Renal cell carcinoma arises from renal tubular cells and is the most common neoplasm of the kidneys. 2) It typically presents as a yellowish or dull white semi-transparent mass with areas of hemorrhage on the cut surface and can spread locally to the renal vein or distantly to bones and lungs. 3) Investigations include blood tests, imaging like ultrasound and CT scan to determine staging according to TNM classification, while treatment involves nephrectomy, with partial or complete removal of the kidney and ureter.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    204 views10 pages

    Renal Cell Carcinoma

    Uploaded by

    'asyura Mohd Reza
    1) Renal cell carcinoma arises from renal tubular cells and is the most common neoplasm of the kidneys. 2) It typically presents as a yellowish or dull white semi-transparent mass with areas of hemorrhage on the cut surface and can spread locally to the renal vein or distantly to bones and lungs. 3) Investigations include blood tests, imaging like ultrasound and CT scan to determine staging according to TNM classification, while treatment involves nephrectomy, with partial or complete removal of the kidney and ureter.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 10

    RENAL CELL

    CARCINOMA
    (Hydronephroma=Grawitz’s tumour)

    ‘ASYURA BINTI MOHD. REZA


    INTRODUCTION
    • Adenocarcinoma
    • The most common neoplasm of kidneys (75%)
    • Arises from renal tubular cells
    • Common in men
    PATHOLOGY

    1) The cut surface : usually yellowish/dull white, semi-transparent with


    areas of hemorrhage.
    2) Tumour is often divided into lobules, some are cystic.
    3) Larger tumour : irregular in shape with central hemorrhage and necrosis.
    MODE OF SPREAD
    • Local spread: renal vein
    • Distant spread : bone
    • Hematogenous spread : through inferior vena
    cava  lungs (Cannonball appearance)
    • Lymphatic spread : para aortic lymph nodes
    and beyond (only when the tumor breach
    Gerato’s fascia)
    CLINICAL FEATURES
    • Asymptomatic in the beginning
    • Triad of loin pain, loin mass & hematuria (10%) 
    indicate advanced disease
    • Hematuria : the most common complaint
    • Left vericocele when tumour spread to left renal
    vein
    • Metastases symptoms : bone pain, chronic
    cough, hemoptysis
    • Atypical symptoms : persistent fever, cachexia,
    anaemia, polycythaemia, hypertension, nephrotic
    syndrome
    STAGING
    INVESTIGATIONS
    INITIAL TEST
    TEST REASON
    Full blood count Anaemia, polycythaemia
    Renal profile Assess remaining renal function
    ESR Increased in RCC
    Serum calcium Hypercalcaemia (Paraneoplastic syndrome)
    Coagulation Pre-surgery investigation
    profile
    Liver function - Impaired in metastases or
    test Paraneoplastic syndrome
    - ALP increase in bone metastases

    Chest x-ray Cannon ball appearance (liver metastases)


    TEST TO CONFIRM DIAGNOSIS & STAGING
    TEST REASON
    Transabdominal ultrasound - To look for origin of mass, cystic/solid
    - Sign of metastases in liver and lymph
    node enlargement
    Contrast CT scan of abdomen - For TNM staging
    - Demonstrate the extent of lesion
    MRI of abdomen If renal function is impaired in order to
    permit contrast
    Transesophageal If suspected spread of tumour from IVC
    echocardiogram involving right atrium
    Excretory urography Able to assess renal function and any filling
    defect indicating presence of mass
    PET scan Most sensitive but not widely available
    TREATMENT
    • RCC responds poorly to radiotherapy or
    conventional chemotherapy.
    • Immunotherapy of cytokine IL-2 shows some
    benefits but still not widely recommended.

    Mainstay of treatment : Nephrectomy


    Partial/ complete nephrectomy and removal of
    ureter and a cuff of bladder
    Types of approach:
    - loin
    - transabdominal
    PROGNOSIS
    • 70% of patients : well after 3 years post-
    nephrectomy
    • 60% of patients : well after 5 years post-
    nephrectomy

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