Clear as mud
What is the classic triad of RCC?
flank pain, palpable mass, hematuria
other: anemia, secondary polycythemia, fever, weight loss
What is the treatment for localized renal cell carcinoma?
What is nephrectomy (partial or radical) or thermal ablation?
This RCC subtype accounts for approximately 75–80% of all renal cell carcinomas.
What is clear cell RCC?
Name three classic risk factors for urothelial (transitional cell) carcinoma of the bladder
What is Pee SAC?
Phenacetin
Smoking
Aromatic amines/aniline,benzidine
Cyclophosphamide
Name the vascular pathway by which a thrombus from RCC can travel to produce a pulmonary embolism.
What is Renal vein → IVC → Right heart → Pulmonary arteries?
Name four paraneoplastic syndromes classically associated with clear cell renal cell carcinoma.
PEAR
PTHrp
Ectopic EPO
ACTH
RENIN
What are the two most common sites of distant metastasis in RCC?
1. Lungs
2. Bones
The cytoplasm of clear cell RCC appears clear because it contains large amounts of these two substances.
What are lipids and glycogen?
Chronic irritation of the bladder from Schistosoma haematobium infection, chronic cystitis, or bladder stones predisposes patients to this type of bladder cancer.
What is squamous cell carcinoma of the bladder?
In a lung region affected by a pulmonary embolism, the V/Q ratio approaches this value.
What is infinity (∞)?
Perfusion falls to zero while ventilation is maintained.
What clinical features suggest a hereditary RCC syndrome rather than sporadic RCC?
Sporadic: Solitary, unilateral, adult males (60s), smoker
Inherited: Multifocal, bilateral, younger (<50), FHx
This TNM finding would generally make RCC unresectable for cure and shift management toward systemic therapy.
What is distant metastasis (M1 disease)?
The second most common RCC subtype (10–15% of cases), characterized histologically by papillary or finger-like projections.
What is papillary RCC?
The most common renal malignancy of childhood is associated with loss-of-function mutations in the ___ and ___ tumor suppressor genes located on this chromosome.
What is WT1 or WT2?
What is chromosome 11?
The left gonadal vein drains into the left renal vein. Compression or invasion of this vessel by RCC may produce this classic clinical finding in males.
What is a varicocele?
The most common RCC subtype arises from epithelial cells of this nephron segment.
What is the proximal convoluted tubule (PCT)?
In RCC, the "N" component of TNM staging refers to metastasis to these regional lymph nodes.
What are the Retroperitoneal nodes?
The third most common RCC subtype (~5% of cases), characterized by large cells with prominent cell membranes ("plant-cell appearance") and eosinophilic or pale cytoplasm.
What is chromophobe RCC?
Renal oncocytoma is a benign renal tumor that arises from this part of the nephron.
What is the collecting duct?
RCC can extend into the right atrium without being considered metastatic disease. Why?
What is direct contiguous venous extension rather than distant spread?
Loss of this tumor suppressor gene on chromosome __ results in increased HIF and VEGF signaling and is the hallmark genetic abnormality of clear cell RCC.
What is Chromosome 3p?
What is the VHL (Von hippel-lindau) gene?
Name one drug (FULL NAME) used for advanced or metastatic RCC (stage 4)
Immunotherapy: Nivolumab, ipilimumab, pembrolizumab (-mab)
Targeted therapy (tyrosine kinase inhibitor/VEGF-targeted therapy): axitinib, cabozantinib, or lenvatinib (-nib)
This rare and highly aggressive RCC subtype arises from the collecting ducts and often presents at an advanced stage.
What is collecting duct carcinoma?
List four features of Beckwith-Wiedemann syndrome
1. Wilms tumor
2. Organomegaly
3. Macroglossia
4. Hemihyperplasia
5. Omphalocele
A 50-year-old patient is worked up for suspected RCC after presenting with hematuria and abdominal fullness. Imaging reveals bilateral renal enlargement rather than a solitary renal mass. What is the most likely diagnosis?
What is ADPKD?