Renal Cancer

Facts

  • The most common type of kidney tumour is Renal Cell Carcinoma (RCC)
  • This is staged using the TNM system
  • Prognosis depends on staging: overall 50% alive at 10 years
  • “Cannon ball metastases” in the lungs are a typical (and common exam question) of metastatic renal cell carcinoma

 

Presentation

  • Often asymptomatic
  • Haematuria
  • Vague loin pain
  • Non-specific symptoms of cancer (e.g. weight loss, fatigue, anorexia, night sweats)

 

Types of Renal Cell Carcinoma

  • Clear cell (75-90%)
  • Papillary (10%)
  • Chromophobe (5%)
  • Collecting duct carcinoma (1%)
  • Children: Wilms Tumour (in children < 5 years old)

 

Risk factors

  • Smoking
  • Obesity
  • Hypertension
  • Long-term dialysis
  • Von Hippel-Lindau Disease

 

Management

  • Surgery (partial nephrectomy first line)
  • /- radiotherapy and chemotherapy depending on disease stage.

 

Paraneoplastic Features

  • Polycythaemia (RCC secretes unregulated erythropoietin)
  • Hypercalcaemia (RCC secretes a hormone that mimics the action of PTH)
  • Stauffer Syndrome (abnormal liver function tests demonstrating an obstructive jaundice – without any localised liver or biliary metastasis!)
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