rcc
TRANSCRIPT
Genito-Urinary Tumors
Episode 4 “The Malignant Evil”
Genito-Urinary Tumors
Renal Cell Carcinoma (RCC)
Renal Cell Carcinoma
Incidence:
• 85% of renal tumors.
• ♂:♀ = 2:1
• Age: 50-70 Yrs.
Renal Cell Carcinoma
Pathology:
• Tubular epithelium.
Renal Cell Carcinoma
Pathology:
• Vary from being nearly completely cystic to being completely solid.
Renal Cell Carcinoma
Pathology:
Bilateral RCCs:1. Von Hippel-Lindau syndrome2. Tuberous sclerosis.3. Chronic dialysis.4. 2% of sporadic cases.
Multicentric RCC:- 25% of patients.
Renal Cell Carcinoma
Pathology:
Spread:1. Direct local invasion of adjacent structures.
2. Local regional lymph node metastases.
3. Extend into the renal vein and, subsequently, into the inferior vena cava.
4. The lungs are the most common sites of distant metastases.
NB: Typically, skeletal metastases are purely lytic.
Renal Cell Carcinoma
Clinical:
• Hematuria, flank pain, or less frequently a flank mass.
• Incidentally during imaging.
• Occasionally, patients present with systemic symptoms such as fever, nausea, anorexia, and weight loss.
• Rarely, patients have symptoms related to humoral factors such as parathormone, prolactin, erythropoietin, or renin.
Renal Cell Carcinoma
Plain X-Ray:
• Normal.
• Distort the normal renal contour.
• Calcifications.
• Metastasis.
Renal Cell Carcinoma
IVU:
• Normal.
• Mass effect on the collecting system.
• Distortion of the renal contour.
• Enlargement of a portion of the kidney.
• Poor or absent contrast material excretion
• Calcifications.
Renal Cell Carcinoma
US:
• Variable solid or cystic.
• RCC can be isoechoic, hypoechoic, or hyperechoic.
Renal Cell Carcinoma
CT:
NECT:
• Isodense, hypodense, or hyperdense.
• Calcifications may be present and are usually amorphous and internal.
• Metastasis.
Renal Cell Carcinoma
CT:
NECT:
• Isodense, hypodense, or hyperdense.
• Calcifications may be present and are usually amorphous and internal.
• Metastasis.
Renal Cell Carcinoma
CT:
NECT:
• Isodense, hypodense, or hyperdense.
• Calcifications may be present and are usually amorphous and internal.
• Metastasis.
Renal Cell Carcinoma
CT:
NECT:
• Isodense, hypodense, or hyperdense.
• Calcifications may be present and are usually amorphous and internal.
• Metastasis.
Renal Cell Carcinoma
CT:
CECT:
• Solid, and evidence of necrosis is often present.
Renal Cell Carcinoma
CT:
CECT:
• Predominantly cystic mass, with thick septa and wall nodularity.
Renal Cell Carcinoma
CT:
CECT:
• Predominantly cystic mass, with thick septa and wall nodularity.
Renal Cell Carcinoma
CT:
CECT:
• Completely solid enhancing mass.
Renal Cell Carcinoma
CT:
CECT:
• Metastasis.
Renal Cell Carcinoma
CT:
CECT:
• Metastasis.
Renal Cell Carcinoma
CT:
CECT:
• Metastasis.
Renal Cell Carcinoma
MRI:
Masses ranging from predominantly cystic with septa or nodularity to solid
with enhancement
Renal Cell Carcinoma
MRI:
T1WI:
• Isointense or hypointense.
• The presence of necrosis or hemorrhage may alter these signal intensity characteristics.
Renal Cell Carcinoma
MRI:
T2WI:
• Hyperintense & heterogeneous
Renal Cell Carcinoma
MRI:
• Metastasis.
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