Topic: Tumours of kidney, cystic diseases Faculty: General Medicine Course: BSc RDT- 2nd year

1. Tumours of kidney
Cystic diseases of kidney
Dr. Salman Ansari
Kanachur Institute of Medical Sciences

2. Tumours of kidney
Two types of tumours:
● Benign. E.g: Adenoma
● Malignant. E.g: adenocarcinoma(renal cell
carcinoma), Wilms’ tumour

3. Adenocarcinoma of Kidney (Synonyms: Renal Cell
Carcinoma, Hypernephroma, Grawitz Tumour)
- Malignant tumour - adenocarcinoma arising from
tubular epithelium
Etiopathogenesis:
- Tobacco
- Genetic factors

4. Classification:
- Clear cell
- Papillary type
- Chromophobe type
- Granular type

6. Clinical features:
- Slow-growing tumour
- Triad of:
- Gross hematuria
- Flank pain
- Abdominal mass

7. Investigations:
- CT or MRI of chest, abdomen and pelvis
Treatment/management:
- Surgical treatment: partial or radical nephrectomy
- Immunotherapy with tyrosine kinase inhibitors

8. WILMS TUMOURS

9. Wilms tumour
● Also called nephroblastoma
● “A malignant tumour of the kidneys, usually
occurring in children younger than 5 years of
age.”
● named after the German doctor, Dr. Max Wilms, who
first described it in 1899
● Most common primary renal tumour of childhood
● Highly malignant primary embryonal tumour

10. Etiology
● Age group: children between 2 and 5 years of age
● Defect in genes
● Pathogenesis: changes in WT1, WTX genes

13. Clinical features
● Asymptomatic abdominal mass in most children
● Abdominal pain
● Hematuria
● Hypertension

14. Diagnosis
Urinalysis, CBC: anemia
USG abdomen, chest X-ray for mets
Treatment
Nephrectomy + chemotherapy

15. Polycystic kidney disease

16. Polycystic kidney diseases
2 types
1. Autosomal recessive (childhood) polycystic kidney
disease(ARPKD)
2. Autosomal dominant (adult) polycystic kidney
disease(ADPKD)

17. Autosomal-dominant (adult) polycystic kidney disease
(ADPKD)
- Multiple thin-walled spherical cysts in cortex and
medulla of both kidneys, which cause destruction
of kidney tissue and lead to renal failure
- More common
- Mutation in PKD1 gene on chromosome 16 or
PKD2 on chromosome 4

18. Clinical features:
- Any age from second decade
- Acute flank or loin pain
- Hematuria
- Subarachnoid hemorrhage due to rupture of berry
aneurysm
- Hypertension
- Renal failure
- polycythemia
Investigations:
- USG abdomen
- MRI
- IVU drooping water lily sign

19. Treatment:
- Control hypertension
- Control pain
- Treat UTI
- Renal dialysis or transplantation
- Vaptans: vasopressin receptor antagonists

20. Questions:
LE:
SE: tumours of kidney
SA:

21. For notes, click here
or scan:
References:
● Archith Boloor, Ramadas Nayak - Exam
Preparatory Manual
Questions:
salman.s.ansari92@gmail.com
For PPT, scan: