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RENAL NEOPLASIA - Coggle Diagram

- - - - Mutation in tumor suppressor genes
        TSC1on chromosome 9 (hamartin)
        TSC2 on chromosome 16
- - - - Fever, weight loss, or paraneoplastic
        syndrome (e.g., EPO, renin, PTHrP,
        or ACTH) may also be present
        
        Pathogenesis:
        LOSS VHL tumor suppressor gene>>
        ↑↑ IGF-1 >> ↑↑ HIF transcription factor>>
        ↑↑VEGF & PDGF
        
        FINDINGS
        
        Gross exam reveals a yellow mass
        
        Histology:most common>> clear cytoplasm (clear cell type)
        
        Staging:
        
        T-based on size and involvement of the renal vein (occurs commonly and increases risk of hematogenous spread to the lungs and bone)
        
        N- spread to retroperitoneal lymph nodes
        
        Sporadic: Adults males (av 60years), single tumor upper pole kidney; major risk cigarette smoke
        
        Hereditary: Young adult, Bilateral, related Von Hippel -Lindau so ↑↑ of hemangioblastoma of cerebellym & renal carcinoma
      - May present with left-sided varicocele:
        Block left renal vein>>left spermatic
        vein>>varicocele