Answer to Pathology MCQ 154

• Renal Cell Carcinoma – hypernephroma/Grawitz tumour
• Arises from proximal renal tubular epithelium
  

Epidemiology

• 90% renal cancers
• Mean age 55 years, male: female is 2:1
• 15% those on renal dialysis develop renal cell carcinoma
  

Clinical features

• 50% incidental findings during abdominal imaging for other symptoms
  
• Haematuria, loin pain, abdominal mass, anorexia, malaise, weigh loss and PUO may all occur
  
• Rarely, invasion of left renal vein compresses testicular vein causing a left varicocele
  
• Spread may be direct, via lymph nodes, or haematogenous (bone, liver, brain)
  

• Bloods – FBC (polycythemia from epo secretion), ESR, U+E, alk phos (bony mets)
• Urine – RBC, cytology
• Imaging – USS, CT/MRI, IVU (filling defect in kidney and calcification)
• Renal angiography if partial nephrectomy or palliation are being considered
• CXR – cannon ball mets

Category: Pathology MCQs