The Kidney’s Got Clues
This classic triad describes the most common symptoms of RCC.
What is flank pain, hematuria, and a palpable mass?
RCC most commonly originates from this segment of the nephron.
What is the proximal convoluted tubule (PCT)?
Increased ACTH from RCC can lead to this endocrine disorder.
What is Cushing's syndrome?
This imaging modality is the most sensitive and specific test for characterizing renal masses and staging RCC.
What is a contrast-enhanced CT scan?
This is the mainstay of treatment for localized RCC.
What is surgical resection (partial or radical nephrectomy)?
RCC can be found incidentally but may present with this nonspecific systemic symptom related to weight.
What is weight loss?
Clear cell RCC is most commonly associated with a mutation in this gene.
What is Von-Hippel-Lindau (VHL) gene deletion on chromosome 3?
This hormone, when secreted ectopically, leads to hypertension in RCC.
What is renin?
T1 RCC is confined to the kidney and less than this size.
What is 7 cm?
Bone metastases from RCC may present with these two symptoms.
What are pain and pathologic fractures?
This is a common paraneoplastic cause of secondary polycythemia in RCC.
What is ectopic EPO production?
Involvement of regional lymph nodes corresponds to this N stage.
Metastasis to lung or bone indicates this M stage.
What is N1?
What is M1?
This rare paraneoplastic syndrome seen in RCC mimics leukemia with extreme leukocytosis but without malignant transformation of WBCs.
What is a leukemoid reaction?
This lab value may be elevated in RCC due to ectopic PTHrP production.
What is calcium?
This type of therapy targets VEGF or mTOR (mammalian target of rapamycin (mTOR) protein) pathways in metastatic RCC.
What are targeted therapies?
A left-sided varicocele might suggest RCC due to involvement of this vessel.
What is the left renal vein?
This lifestyle factor significantly increases the risk of RCC.
What is smoking?
RCC extension into the IVC can cause this hepatic venous outflow obstruction syndrome.
What is Budd–Chiari syndrome?
RCC tumors appear this color due to high lipid content.
What is golden-yellow?
This checkpoint inhibitor, often combined with nivolumab, targets CTLA-4 and is approved for advanced RCC.
What is ipilimumab?
This RCC-associated paraneoplastic syndrome causes elevated serum calcium.
What is PTHrP-mediated hypercalcemia?
This histologic variant of RCC originates from the medullary collecting duct and has a poor prognosis with aggressive behavior.
Collecting duct carcinoma (Bellini duct carcinoma)
Chronic inflammation from RCC may lead to this secondary amyloidosis.
What is AA amyloidosis?
This anatomical structure surrounding the kidney serves as a staging landmark; extension beyond it classifies RCC as T4.
What is Gerota’s fascia?
This targeted therapy class inhibits angiogenesis by blocking VEGF and is a mainstay in metastatic RCC.
What are VEGF tyrosine kinase inhibitors
Bonus name 2