Renal cell carcinoma

32,939views

00:00 / 00:00

High Yield Notes

9 pages

Flashcards

Renal cell carcinoma

de completadas

Preguntas

Preguntas del estilo USMLE Step 1

de completadas

A 52-year-old man comes to the clinic because of vague right-sided back pain over the past two months. He denies any recent trauma, heavy lifting, or new activity. The patient has also noticed a 4.2 kg weight loss during this time, despite not making any changes to diet or activity. The patient has a 20 pack-year smoking history. The patient’s temperature is 37.8°C (100°F), pulse is 75/min, and blood pressure is 128/85 mm Hg. Physical examination shows no abnormalities. The results of his urinalysis are shown below:  
 
Laboratory value   Result 
 Urinalysis 
 Erythrocytes  60/hpf 
 Leukocytes  4/hpf 
 Bacteria  None 
Which of the following is a possible complication of this patient's condition?  

External References

First Aid

2024

2023

2022

2021

Chromosome disorders

renal cell carcinoma p. 617

Obesity

renal cell carcinoma association p. 617

Paraneoplastic syndromes p. 219

renal cell carcinoma and p. 617

Proximal convoluted tubules (PCT)

renal cell carcinoma and p. 617

Renal cell carcinomas p. 617

associations p. 734

bevacizumab for p. 445

carcinogens for p. 221

chromosome association p. 62

horseshoe kidney and p. 597

hypercalcemia and p. 219

IFN- αfor p. 200

immunohistochemical stain for p. 218

metastases of p. 202

recombinant cytokines p. NaN

therapeutic antibodies p. 120

von Hippel-Lindau disease p. 539, 725

Smoking

renal cell carcinoma p. 617

Von Hippel-Lindau disease p. 539

renal cell carcinoma and p. 617

Weight loss

renal cell carcinoma p. 617

Enlaces externos

Transcript

Watch video only

Renal cell carcinomas (or RCC’s) are the most common type of malignant kidney cancer in adults, generally affecting older men.

Unfortunately, RCC is often considered a “silent” cancer because symptoms don’t typically get noticed until the tumor has grown pretty large.

Renal cell carcinomas form from epithelial cells in the proximal convoluted tubule of the kidney; this is the section of the nephron that is usually located in the renal cortex—the outer rim of the kidney.

The most common type of renal cell carcinoma is composed of polygonal epithelial cells, which have funny angular shapes with at least four sides and are filled with clear cytoplasm full of carbohydrates and lipids. It’s those lipids that give the tumors their yellow color.

At a genetic level, renal cell carcinomas have been linked to mutations on the short arm of chromosome 3, or 3p. An easy way to remember this is that RCC has three letters and it’s linked to chromosome 3.

One of the main genes involved in renal cell carcinomas is the VHL gene, which codes for the von Hippel-Lindau tumor suppressor protein, or pVHL which is normally expressed in all tissues.

Mutations in pVHL can allow IGF-1, the type 1 insulin-like growth factor, pathway to go into overdrive. This does two things.

First, there is dysregulated cell growth, and second it upregulates specific transcription factors called hypoxia-inducible factors, which in turn help generate more vascular endothelial growth factor or VEGF, as well as VEGF receptor, leading to growth of new blood vessels, or angiogenesis. Dysregulated cellular growth and angiogenesis are a recipe for tumor formation.

Renal cell carcinomas can arise sporadically or they can be a part of an inherited syndrome. Sporadic tumors are usually solitary tumors in the upper pole of the kidney, and most often happen among older men that smoke cigarettes.

Inherited syndromes, like von Hippel-Lindau disease, can also give rise to renal cell carcinomas, and in this situation the tumors typically affect younger men and women and often involve both kidneys.

Von Hippel Lindau disease is a rare autosomal dominant disorder characterized by a mutation in a tumor suppressor gene which leads to the formation of cysts and benign tumors in various parts of the body like the eye and central nervous system.

Resumen

Renal cell carcinoma (RCC) is a type of kidney cancer that originates in epithelial cells in the proximal convoluted tubule of the kidney. RCCs are the most common type of malignant kidney cancer in adults, generally affecting older men. RCCs can arise sporadically or as part of a genetic condition like von Hippel-Lindau's disease. Symptoms may include blood in the urine, abdominal pain, and a mass in the kidney area. Treatment options include surgery, radiation therapy, and immunotherapy.

Fuentes

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Renal cell carcinoma" Current Opinion in Oncology (2008)
  6. "Renal-Cell Carcinoma" New England Journal of Medicine (2005)
  7. "Renal cell carcinoma" The Lancet (2009)
Elsevier

Copyright © 2024 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

RELX