Which of the following factors is associated with increased survival in patients with metastatic kidney tumors?
physically active patients with good performance status
extirpation of the primary tumor
long disease-free interval between initial nephrectomy and the emergence of secondaries
all of the above
Correct Answer :
D. all of the above
self-explanatory.
Related Questions
Fuhrmans grading system for renal cell carcinoma relies on:
nuclear size, outline, and nucleoli
cohesiveness and the degree of cellular atypia
chromatin structure and content of the interphase nucleus
multinucleation and mitosis
The etiology of renal cysts includes all of the following, EXCEPT:
autosomal dominant polycystic kidney disease (ADPKD)
developmental cystic renal disease
inherited cystic renal disease
systemic disease with associated renal cysts
Inherited renal cystic disease(s) include(s) the following:
glomerulocystic kidney disease (GCKD)
Juvenile nephronophthisis (JNPHP)
medullary cystic kidney disease
all of the above
Routine metastatic evaluation in RCC cases should include all of the following, EXCEPT:
abdominal CT
chest X-ray
renal function test
liver function test
What is true regarding renal angiomyolipoma (AML)?
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
What is false concerning renal oncocytoma?
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
The likelihood of malignancy in category IIF (indeterminate) renal cysts is:
20%
30%
40%
50%
According to Fuhrmans classification system for nuclear grading in RCC, nuclear size of 20 μg with irregular outline and prominent nucleoli is grade:
1
2
3
4
What is the most powerful single predictor of oncologic outcomes in RCC cases?
margin status and grade
tumor size
tumor stage
the time interval between the tumor emergence and excision
What is false concerning renal angiomyolipoma (AML)?
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
What is false concerning ADPKD patients?
hepatic cysts are the most common extra-renal manifestation
might experience cyst hemorrhage, renal infection, or nephrolithiasis
typically, complain of flank pain or intermittent hematuria in the early twenties
hypertension and CRF commonly occur in the fifth decade of life
d. prior to kidney transplant
. What is an indication for radical nephrectomy?
a 6-cm, polar tumor
bilateral RCC
locally advanced RCC
On histological examination of a resected renal tumor, the presence of multiple mitochondria observed on electron microscopy is diagnostic for:
renal oncocytoma
multiloculated cystic nephromas
metanephric adenoma
adenoma with clear cell
In a localized RCC, local recurrence after tumor ablation therapy is managed by any of the following options, EXCEPT:
repeat ablation
active surveillance
salvage surgery
radical nephrectomy
What is true regarding cancer incidence in renal cystic diseases?
is > 90% in Bosniak type IV renal cysts
in patients receiving renal transplants for polycystic kidney disease is 48% higher than that expected in the general population
all of the above
simple renal cysts might turn malignant in < 4% of cases
What is the treatment of a 3-cm renal mass suggestive of RCC adjacent to a huge renal cyst?
cyst aspiration and sclerosis
partial nephrectomy
endoscopic marsupialization and fulguration of the cyst
administration of TKIs
On histological examination of a resected renal tumor, positive staining for human melanoma black (HMB)-45 is a distinctive and diagnostic feature for:
multiloculated cystic nephromas
angiomyolipoma
metanephric adenoma
adenoma with clear cell
d. none of the above
. 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 can NOT be a manifestation of a renal tumor?
right hydrocele
left varicocele
painless hematuria
hypertension
d. hypertension
. Metastatic tumors to the kidney are common from all of the following organs, EXCEPT:
lungs
thyroid
breasts
d. neurosarcoma
. What is false concerning targeted molecular therapy?
is a personalized medical therapy devised to meet each persons individual needs for cancer`s specifications
treats cancer by interrupting unique molecular abnormalities that drive cancer growth
some cancer types have different molecular targets
What type of Bosniak renal cysts accompanies tumor masses in 5% of cases?
I
II
III
IV
On ultrasonography, what are the percentages of incidentally discovered renal masses that will later be malignant on further workup?
70 - 85%
55 - 70%
40 - 55%
25 - 40%
In RCC cases where IVC involvement with tumor thrombi are suspected, venacavography:
is the first and most reliable radiologic examination to study IVC thrombi
is reserved for patients with equivocal MRI or CT findings
is obsolete and has fallen out of use
carries a risk of IVC terrible bleeding that outweighs the diagnostic merits
d. 30 - 40%
. 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
Which of the following is NOT a risk factor for RCC?
type II DM, especially in males
hypertension
obesity, especially in females
cigarette smoking
d. CT can detect renal vein involvement in 82-95% of cases and vena caval involvement in 95-100% of cases
. In RCC, ipsilateral adrenal metastasis occurs in:
0.3 - 2%
2 - 10%
11 - 18%
What is true regarding ADPKD patients?
progress to ESRD in the sixth decade of life
hypertension is seen in 80% of patients with ADPKD aged 20-34 years
aortic valve stenosis in 25%
manifestations are more significant in patients with the PKD2 genotype
Which of the following conditions carries the worst prognosis?
acquired cystic renal disease
juvenile nephronophthisis
medullary sponge kidney
bilateral multicystic dysplastic kidney
After radical nephrectomy for organ-confined RCC, what is (are) the recommended surveillance radiologic examination(s)?
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