Malignancy causing flank pain

MALIGNANCIES ASSOCIATED WITH FLANK PAINRENAL CELL CARCINOMAAdenocarcinoma from tubular epithelial cells (PCT)
(80-90% of malignant tumors of the kidney)RISK FACTORS: 
men > women (60-70 yo) | smoking | obesity | ACKD in ESRD | 
von Hippel-Lindau dseHISTORY / PE:
painless hematuria | flank pain | palpable flank mass |
wt. loss | malaise | fever | left sided varicocele |fatigue |
anemia | polycythemiaDIAGNOSTICS:RENAL UTZ | CT | histologyTREATMENT:Surgical resection | radiation / chemo VON HIPPEL-LINDAU DISEASEAn INHERITED CANCER SYNDROME with renal manifestationscaused by mutations in VHL tumor suppressor gene. MANIFESTATIONS: 
Multiple bilateral kidney cysts | renal cell ca | kidney cysts and 
ca affects majority of VHL aeg. |
Non-renal features : pheochromocytomas | 
cerebellar hemangioblastoma | retinal hemangioblastomas | DIAGNOSTICS:annual screening of the kidneys ~ CT / MRI MANAGEMENT : - Nephron-sapring surgical approaches for removal of
cancerous lesionsPROSTATE CANCERmost common ca in men. 
2nd leading cause of ca death in menRISK FACTORS:advanced age | + family historyHISTORY / PE:ASYMPTOMATIC | may present as obstructive urinary sx | 
lymphedema due to obstructing metastases | back pain |
palpable nodule in DRE | tender prostate ~ prostatitisDIAGNOSTICS:
markedly increased PSA ( >4 ng/mL) | utz0guided transrectal
biopsy | Gleason histologic syst. | CT to look for metastases
| bone scanTREATMENT:observation | Radical prostatectomy | radiation therapy | PSA |
androgen ablationPANCREATIC CANCER"SILENT DSE"manifests as dull left flank painnegative findings on an UTZ study (symptoms can be quite vague, and theycan vary depending on the location of cancer in the pancreas)TRANSITIONAL CELL CARCINOMAMANIFESTATIONS:
painless hematuria | flank pain that doesnt go away |
suprapubic fullness pain |fatigue |weight loss| painful or
frequent urination | hydronephrosisMOST COMMON tumor of UTS (renal calyces, renal pelvis
ureters, bladders) 
~Arise in th UT outside of kidney, predominantly in the bladder,
originating form transitional epithelium associated with problems in your Pee SAC:
phenacetin | Smoking | Aniline Dyes | Cyclophosphamideaffect men > women (50 - 70 years)DIAGNOSIS:Cystoscopy | urine cytology | pelvic CTTREATMENT:~ Transurethral resection / injection of chemotherapeutic 
agents into the bladder. 
~ Cystectomy
~ Radiation / Chemotherapy / bothCOMMON FORMS:
~CLEAR CELL CA (80%)
~PAPILLARY RENAL CA (15%)
~ CHROMOPHOBE RENAL CA (<5%)aisha aa.
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