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29 Cards in this Set

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  • Back
What is the most common type of renal cell carcinoma?
Clear Cell Carcinoma
In order, what are the 2 most common primary renal malignant masses?
renal cell carcinoma (90%)

2nd most common is transitional cell carcinoma in the ureter.
What are the 3 criteria for distinguishing a simple renal cyst from a complex renal cyst?
ultrasound
1) anechoic (black in center)
2) smooth walled
3) posterior enhancement
What is the most common renal lesion, occuring in ca. 10% of the population?
simple renal cyst (benign, no treatment or followup required)
Describe the 4 complex renal cyst types based on the Bosniak Classification and how they should be treated.
1) Type 1
- simple cyst
- No Tx or followup required

2) Type 2
- thick walled/border forming calcification
- 20-25% become malignant
- monitor

3) Type 3
- septations/non-border forming calcifications
- 50% malignant
- surgery or closely monitor

4) Type 4
- Solid and Cystic Areas
- 50-75% become malignant
- surgery
Name the 3 most common benign renal masses.
1) renal papillary adenoma
2) oncocytoma
3) angiomyolipoma
How should a renal papillary adenoma be treated?
Difficult to discern from renal cell carcinoma. Therefore, if:

< 3cm observe
> 3cm excise or ablate
A brown well-defined mass is discovered in the kidney, which on biopsy was shown to have large cells with round regular nuclei and abundant eosinophilic granular cytoplasm. Grossly, it had a stellate central scar. What kind of tumor is this most likely to be?
oncocytoma
How should an oncocytoma be treated?
As it is difficult to differentiate from RCC, it should be removed. Later after biopsy and diagnosis the patient can be reassured.
What tissues make up an angiomyolipoma?
1) vascular
2) muscle
3) fat
What are the 2 forms of angiomyolipoma (AML)?
1) sporadic - majority of cases and most often in middle-aged women. Usually solitary and small.

2) form seen with tuberous sclerosis - more likely to be bilateral, multiple and large
How should an angiomyolipoma be treated?
benign if <6cm and can just observe. If >6cm, possibiity of massive hemorrhage or local discomfort. Can embolize or excise.
How does an angiomyolipoma appear on an ultrasound? on a CT Scan?
a) ultrasound: hyperechoic (lipids reflect sound well and will appear white)

b) CT: fat will be hypodense (dark) and vascular tissue will be hyperdense (white)
Do renal cell carcinomas appear more frequently in men or women?
men
What are the 5 classifications of renal cell carcinomas?
1) clear cell (most common)
2) papillary (sporadic and familial variants)
3) chromophobe (very good prognosis)
4) collecting duct carcinoma (rare, highly agressive, very poor prognosis)
5) idiopathic
What is the most common type of renal cell carcinoma?
Clear Cell Carcinoma
In order, what are the 2 most common primary renal malignant masses?
renal cell carcinoma (90%)

2nd most common is transitional cell carcinoma in the ureter.
What are the 3 criteria for distinguishing a simple renal cyst from a complex renal cyst?
ultrasound
1) anechoic (black in center)
2) smooth walled
3) posterior enhancement
What is the most common renal lesion, occuring in ca. 10% of the population?
simple renal cyst (benign, no treatment or followup required)
Describe the 4 complex renal cyst types based on the Bosniak Classification and how they should be treated.
1) Type 1
- simple cyst
- No Tx or followup required

2) Type 2
- thick walled/border forming calcification
- 20-25% become malignant
- monitor

3) Type 3
- septations/non-border forming calcifications
- 50% malignant
- surgery or closely monitor

4) Type 4
- Solid and Cystic Areas
- 50-75% become malignant
- surgery
What is the most common type of renal cell carcinoma?
Clear Cell Carcinoma
In order, what are the 2 most common primary renal malignant masses?
renal cell carcinoma (90%)

2nd most common is transitional cell carcinoma in the ureter.
What are the 3 criteria for distinguishing a simple renal cyst from a complex renal cyst?
ultrasound
1) anechoic (black in center)
2) smooth walled
3) posterior enhancement
What is the most common renal lesion, occuring in ca. 10% of the population?
simple renal cyst (benign, no treatment or followup required)
Describe the 4 complex renal cyst types based on the Bosniak Classification and how they should be treated.
1) Type 1
- simple cyst
- No Tx or followup required

2) Type 2
- thick walled/border forming calcification
- 20-25% become malignant
- monitor

3) Type 3
- septations/non-border forming calcifications
- 50% malignant
- surgery or closely monitor

4) Type 4
- Solid and Cystic Areas
- 50-75% become malignant
- surgery
What are the Treatment options for RCC?
1) radical nephrectomy (wntire kidney, fascia, lymph nodes, in some cases adrenal glands)

2) partial nephrectomy
- bilateral lesions
- solitary kidney
- small lesions
- progressive renal disease

3) ablation
- radio frequency ablation
- cryoablation
How would a RCC appear on a CT scan?
solid (grey) areas and cystic (white) areas
What is the most common site for RCC metastasis?
lungs

(then lymph nodes, liver, bones; if migrates to brain, poor prognosis ~3mos)
How should metastatic RCC be treated?
1) surgical excision (solitary)
2) immunotherapy (insterferon, interleukin)- multiple
3) tyrosine kinase inhibitor- $$$, 5-10yrs may replace immunotherapy

4) hormonal
5) chemotherapy