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pathophysiology of adeno carcinoma

pathophysiology of adeno carcinoma

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Published by Irish May Tana

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Published by: Irish May Tana on Oct 27, 2010
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03/16/2014

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PATHOPHYSIOLOGY OF RENAL ADENOCARCINOMA
Schematic Diagram with Treatment and Disease Prognosis
Risk Factors
Predisposing Factors
Precipitating Factors
Cigarette
smoking
Obesity
Hypertension
Family history
of the disease
Occupational
exposure to
industrial
chemicals
Age: 40
- 70
Gender
: Male
Long
term
Inherited disorders
1.Von hippel Lindau
disease – del 3p
2.
Hereditary
papillary renal
cancer - MET
3.
Hereditary
leiomyoma RCC
syndrome –
Mutation in VHL genes
Inability to modify
HIF1a
Defective VHL
Activation of HIF
HIF1A subunits accumulate and bind to HIFB
Metaplasia
Dysplasia
Kidney operates in non hypoxic
Activation of HIF1A in oxygenated
Uncontrolled activation of genes that encode for proteins (VEGF and
erthyropoietin)
Induces the expression of a number of angiogenesis related factors
H1F1A tipped towards HIF2A and interacts with Cyclin D1
Tumorigenesi
Abnormal exocrine function of the cell
Tumor formation in the renal tubular epithelium
Mali nant Tumors
Cell starvation
Lipolysis
Cachexia
Weight loss
Weakness
Tumor will grow
Absorption of surrounding cell nutrients
Signs and Symptoms
Hematuria
Loin Pain
Abdominal Mass
Malaise, weight loss or anorexia
Polycythemia
Anemia
The presenting symptom may be due to metastatic disease, such as a pathologic fracture of the hip due to a metastasis to
the bone
Varicocele
Vision Abnormalities
Pallor or Plethora
Hirsutism
Constipation
Hypertension
Elevated calcium levels (Hypercalcemia)
Paraneo lastic disease
Diagnostics and Laboratories
Urinalysis
Complete blood count (CBC),
SGPT (also called ALT) and alkaline
phosphatase
IVP
Kidney x-ray, Chest x-ray
Liver function tests
Renal arteriography
Serum calcium
Ultrasound of the abdomen and
kidney
Treatment Modalities
Medical Intervention
Oral Chemotherapeutic Drugs –
Sorafenib Tosylate
Vaccines –
Interleukin-2 (IL-2) and -
interferon
Surgical Intervention
Radical nephrectomy
Partial nephrectomy
Renal-sparing surgery
Lymphadenectomy
Preemptive medullary rod
placement

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