Which is not true for renal cell carcinoma: March 2011

Ans. A : Progesterone increase tumour size Renal adenocarcinoma is twice as common in males as in females; Microscopically 'clear cell carcinomas' are more common than 'granular cell' tumours There is early spread of the tumour into the renal pelvis and along the renal vein, often extending into the IVC RCC/ hypernephroma/adenocarcinoma/Grawitz tumour MC primary malignant renal tumour (90-95%) Causes: - Smoking, - Obesity, - Genetic predisposition (von-Hippel Lindua syndrome) Tuberous sclerosis - Polycystic kidney disease - Anomalies on gene 3 Mostly arises from epithelial cells of proximal tubules Clear cell carcinoma (60%) is the commonest category Classical presenting signs and symptoms include hematuria, abdominal pain and abdominal mass Causes expansile osteolytic lesions Clinical features: - Hypeension - Cushings syndrome - Galactorrhea - Pyrexia of unknown origin Associated paraneoplastic syndromes: - Erythrocytosis - Hypercalcemia Non-metastatic hepatic dysfunction - Acquired dysfibrinogenemia MC metastasis is to lung, soft tissue, bone and liver Robsons staging is done Radical Nephrectomy (for stage I and II, selected stage III cases)