. What is an indication for radical nephrectomy?
a 6-cm, polar tumor
bilateral RCC
locally advanced RCC
C. bilateral RCC
papillary subtype of RCC has a tendency to multifocality
chromosome 13 alterations are common in the development of clear cell renal carcinoma
a solid mass on CT that enhances more than 15 HU is suggestive of RCC
bilateral involvement in RCC either synchronously or metachronously occurs in 2% to 4% of patients
nuclear size, outline, and nucleoli
cohesiveness and the degree of cellular atypia
chromatin structure and content of the interphase nucleus
multinucleation and mitosis
. What is NOT an indication for simple nephrectomy?
symptomatic chronic renal infection with poor function
some cases of renovascular hypertension
symptomatic calculus disease with poor renal function
. What is false concerning imaging studies for preoperative evaluation of RCC case?
in case of bone pain or elevated serum calcium and/or alkaline phosphatase levels, an isotopic bone scan is required
renal arteriography accurately localizes central scaring and tumor necrosis
trans-esophageal echocardiography helps assess vena caval and right atrial tumor thrombi
glomerulocystic kidney disease (GCKD)
Juvenile nephronophthisis (JNPHP)
medullary cystic kidney disease
all of the above
. Metastatic tumors to the kidney are common from all of the following organs, EXCEPT:
lungs
thyroid
breasts
male gender
hypertension
renal insufficiency
all of the above
at autopsy
by staining positive for human melanoma black (HMB)-45
by fine-needle aspiration cytology
by exclusion
80%
85%
90%
95%
. What is the relapse rate for completely resected RCC after radical nephrectomy?
1- 10%
10 - 20%
20 - 30%
clear cell
chromophobe
papillary
renal medullary
. What is false regarding radical nephrectomy operation?
nodal involvement doesn`t influence prognosis
renal artery should be ligated before the vein to avoid kidney ballooning
cardiopulmonary bypass with deep hypothermic circulatory arrest is performed in patients with supra-diaphragmatic tumor thrombi
the central scar on CT or MRI, and the spoke-wheel pattern of vessels on angiograms are not specific to oncocytoma
calcification, necrosis, and hemorrhage are rare in oncocytomas
it is thought to arise from the basement membrane of proximal convoluted tubules
treatment is partial nephrectomy or tumor excision
fibrosarcoma
leiomyosarcoma
carcinoid
adult Wilm`s tumor
chest X-ray and abdominal ultrasonography every 3 months for the first year, and then annually for 3 years
annual chest X-ray for 3 years
abdominal and chest CT every 6 months for the first year, and then annually for 3 years
no radiological examination required
I
II
III
IV
multiloculated cystic nephromas
angiomyolipoma
metanephric adenoma
adenoma with clear cell
renal oncocytoma
multiloculated cystic nephromas
metanephric adenoma
adenoma with clear cell
most classic AMLs eventually undergo malignant transformation to sarcomatoid and epithelioid AML
the preferred treatment is nephroureterectomy followed by active surveillance
angiographic embolization and/or nephron-sparing surgery is advised for symptomatic AMLs greater than 4 cm
extra-renal sites include the pancreas, salivary glands, and thyroids
never
unlikely
likely
always
< - 10 HU
< - 20 HU
< 10 HU
< 20 HU
hyperattenuating renal cyst
solitary renal cyst
uncomplicated renal cyst
focal renal cyst
the quality of the kidney and renal function prior to surgery
the quantity of vascularized parenchymal mass preserved after excision
the tumor
warm ischemia time
RCC occurs in < 5% of patients with tuberous sclerosis
in glomerulocystic kidney disease, renal tumors are typically solitary, large, with central necrosis
in Von Hippel-Lindau syndrome, renal tumors are frequently bilateral and multicentric
in acquired cystic disease, tumors are commonly bilateral, and metastatic in 15% of cases
acquired cystic renal disease
juvenile nephronophthisis
medullary sponge kidney
bilateral multicystic dysplastic kidney
. In RCC, ipsilateral adrenal metastasis occurs in:
0.3 - 2%
2 - 10%
11 - 18%
most lesions ≤ 4 cm are asymptomatic
renal masses with fat content is pathognomonic for AML
renal biopsy from AML carries a high risk of hemorrhage
may coexist with malignant lesions, such as sarcomas and RCCs
RCC
AML
teratoma
any of the above
never
unlikely
likely
always
margin status and grade
tumor size
tumor stage
the time interval between the tumor emergence and excision