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Renal Tumors

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Renal Tumors

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    1. Renal Tumors 9/18/2012 School of Medicine/JUST

    2. CLASSIFICATION OF RENAL TUMORS 9/18/2012 School of Medicine/JUST

    3. 9/18/2012 School of Medicine/JUST

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    8. Renal cystic lesions classification scheme 9/18/2012 School of Medicine/JUST

    9. Category I lesions are uncomplicated, simple, benign cysts of the kidney that are straightforward to diagnose on ultrasonography, CT scan, or MRI scan. 9/18/2012 School of Medicine/JUST

    10. Category II lesions Are minimally complicated cysts that are benign but have some radiologic findings that cause concern Include septated cysts, cysts with minimal calcium in the wall or septum, infected cysts, and hyperdense (high-density) cysts. 9/18/2012 School of Medicine/JUST

    11. Category III lesions are more complicated renal cysts that are indeterminate and cannot be confidently distinguished from malignancy. The radiographic features include an irregular margin, thickened septa, and thick irregular calcification 9/18/2012 School of Medicine/JUST

    12. Category IV lesions large cystic components; irregular, shaggy margins; and, most importantly, some solid enhancing portions that provide a definitive diagnosis of malignancy 9/18/2012 School of Medicine/JUST

    13. Renal Cell I 9/18/2012 School of Medicine/JUST

    14. Renal Cyst II 9/18/2012 School of Medicine/JUST

    15. Renal Cyst III 9/18/2012 School of Medicine/JUST

    16. Renal Cyst IV 9/18/2012 School of Medicine/JUST

    17. BENIGN RENAL TUMORS Arise from cortical tissue (e.g., adenoma, oncocytoma) or from the various mesenchymal derivatives within the parenchyma or capsule of the kidney. Differentiation from malignant renal masses by radiographic or clinical means can be challenging. 9/18/2012 School of Medicine/JUST

    18. Benign Renal Cyst Solitary or multiple Found in more than 50% of patients older than 50 years. 9/18/2012 School of Medicine/JUST

    19. Renal Cortical Adenoma Metanephric Adenoma Oncocytoma Angiomyolipoma (Approximately 20% of AMLs are found in patients with tuberous sclerosis syndrome (TS), an autosomal-dominant disorder characterized by mental retardation, epilepsy, and adenoma sebaceum, a distinctive skin lesion) 9/18/2012 School of Medicine/JUST

    20. Multiloculated Cystic Nephroma 9/18/2012 School of Medicine/JUST

    21. RENAL CELL CARCINOMA accounts for 3% of all adult malignancies 9/18/2012 School of Medicine/JUST

    22. The incidence of RCC has increased since the 1970s by an average of 3% Ultrasound and CT.SCAN 9/18/2012 School of Medicine/JUST

    23. Etiology 9/18/2012 School of Medicine/JUST

    24. Potential etiologic factors have been identified in animal models, including viruses, lead compounds, and more than 100 chemicals such as aromatic hydrocarbons, no specific agent has been definitively established as causative in human RCC. Tobacco 9/18/2012 School of Medicine/JUST

    25. Familial Renal Cell Carcinoma Von Hippel–Lindau Disease Major manifestations include the development of RCC, pheochromocytoma, retinal angiomas, and hemangioblastomas of the brain stem, cerebellum, or spinal cord 9/18/2012 School of Medicine/JUST

    26. The classic triad of flank pain, gross hematuria, and palpable abdominal mass is now rarely found Paraneoplastic syndromes are found in 20% of patients with RCC, 9/18/2012 School of Medicine/JUST

    27. 9/18/2012 School of Medicine/JUST

    28. Prognostic Factors Specific clinical signs or symptoms, Tumor-related factors, and various laboratory findings. Of these, tumor-related factors such as pathologic stage, tumor size, nuclear grade, and histologic subtype have proved to be the most useful Pathologic stage has proven to be the single most important prognostic factor for RCC 9/18/2012 School of Medicine/JUST

    29. Septated cyst, two examples. A, Sonogram shows a thin septum traversing an otherwise simple cyst. Note the adjacent echogenic renal cell carcinoma (arrowhead). B, CT scan shows a partial septum (arrowheads) within a large cyst. School of Medicine/JUST 9/18/2012

    30. Renal cell carcinoma. A, Excretory urography with tomography displays a low-density mass causing a focal bulge (arrows) in the lower pole of the right kidney. The mass causes displacement and stretching of the adjacent calyces. B, A contrast-enhanced CT scan clearly indicates the solid but heterogeneous nature of the tumor. The perinephric fat and renal fascia (arrow) are normal, suggesting tumor confinement within the renal capsule. Pathological examination revealed a stage I renal cell carcinoma School of Medicine/JUST 9/18/2012

    31. Renal cell carcinoma invading the collecting system. A, Excretory urography shows a filling defect (arrowheads) in the infundibula of the midregion and lower pole calyces. B, Tomography shows a lucent region (arrowheads) in the nephrogram in the midregion and lower pole. C, On contrast-enhanced CT the neoplasm (arrow) invades the collecting system (arrowhead). School of Medicine/JUST 9/18/2012

    32. Central renal cell carcinoma mimicking a transitional cell lesion in a 70-year-old woman with a peripheral neuropathy. A low-density, irregular, ill-defined tumor is seen invading medially while preserving the reniform outline of the kidney. This tumor cannot be differentiated from a transitional cell carcinoma by computed tomography School of Medicine/JUST 9/18/2012

    33. Management Radical Nephrectomy Nephron Sparing Surgery Palliative Surgery Chemotherapy Radiotherapy 9/18/2012 School of Medicine/JUST

    34. Pediatric Rrnal Tumors. 9/18/2012 School of Medicine/JUST

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