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RENAL NEOPLASM

CLASSIFICATION . BENIGNAdenomaAngiomaAngiomyolipomaMALIGNANTWilm's tumour/ NephroblastomaGrawitz's tumour/ Adenocarcinoma/ HypernephromaTransitional cell carcinomaSquamous cell carcinoma. . Of renal pelvis. www.similima.com. 2. RENAL CELL CARCINOMA. Also known as:HYPERNEPHROMAGRAWITZ'S TU

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RENAL NEOPLASM

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    1. www.similima.com 1

    2. CLASSIFICATION BENIGN Adenoma Angioma Angiomyolipoma MALIGNANT Wilms tumour/ Nephroblastoma Grawitzs tumour/ Adenocarcinoma/ Hypernephroma Transitional cell carcinoma Squamous cell carcinoma www.similima.com 2

    3. RENAL CELL CARCINOMA Also known as: HYPERNEPHROMA GRAWITZS TUMOUR Common type of malignant renal neoplasm,arise from renal tubular cell Incidence: 75% Age group: 40-60yrs Male:Female=2:1 www.similima.com 3

    4. AETIOLOGY 6C: Chromosomal defect Cigarette smoking Coffee drinking Cadmium exposure Chronic cystic disease Congenital disease www.similima.com 4

    5. RISK FACTORS Diabetes Mellitus Chronic dialysis www.similima.com 5

    6. Cells of origin: Proximal renal tubular system Starts in one of the poles; commonly upper pole Reniform shape of kidney is maintained Cut surface: Homogenous yellowish in colour due to lipid deposition,few haemorrhagic areas are common Microscopy: Alternate clear & dark cells,Scanty stroma-richly vascular PATHOLOGY www.similima.com 6

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    9. SPREAD Blood spread: Tumour cells Lymphatics Lymph node in hilum Distant metastasis to long bone (Secondary deposit) www.similima.com 9

    10. CLINICAL FEATURES Triad of RCC Pain: Dragging /Intermittent clot colic due to blood clot blocking the ureter Intermittent hematuria Palpable long mass www.similima.com 10

    11. OTHER MANIFESTATIONS Bone: Pathological fracture Secondaries Bony pain Haematological Anemia Polycythemia Hyperglobulinemia www.similima.com 11

    12. Endocrinological Hypertension Hypercalcemia Mild elevation of temperature: 37.8C-38.9C Nephrotic syndrome: rare Liver dysfunction www.similima.com 12

    13. ROBSONS staging Stage 1: Limited to kidney Stage 2: Invade perinephric tissue,doesnt extend beyond Gerotas fascia Stage 3: Extend to major vein or lymph node Stage 4: Distant metasatasis www.similima.com 13

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    15. INVESTIGATIONS Urine examination done when the patient has hematuria to see malignant cells Plain X-ray: Abnormal calcification in tumour Intravenous urography: Hematuria Ultrasonography CT scan MRI Renal angiography Venacavogram: To know extend of tumour in inferior venacava www.similima.com 15

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    17. TREATMENT Radical nephrectomy Radical nephrectomy with extraction of thrombus Nephro sparing surgery Therapeutic embolization Radiotherapy Immunotherapy www.similima.com 17

    18. PROGNOSIS Removal of even the largest neoplasm may cure the patient 70% of the patients well after 3yr 60% after 5yr www.similima.com 18

    19. TRANSITIONAL CELL CARCINOMA It invade the ranal parenchyma Have a tendency to multifocal & distant spread Hematuria is the most common symptom www.similima.com 19

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    22. INVESTIGATIONS Urine examination for presence of malignant cell Intravenous urography www.similima.com 22

    23. TREATMENT Nephroureterectomy www.similima.com 23

    24. SQUAMOUS CELL CARCINOMA Rare variety Associated with chronic inflammation & leucoplakia resulting from stone Radiosensitive but matastasis early www.similima.com 24

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