PAEA Surgery End Of Rotation (EOR) Practice Exam

Which sites are the most common metastasis locations for kidney cancer?

1. Brain and liver

2. Skin and lymph nodes

3. Lungs and bone

4. Abdomen and pelvis

The correct answer is: Lungs and bone

Kidney cancer, particularly renal cell carcinoma, has a well-established pattern of metastasis. The most common sites for metastasis are the lungs and bones. This is attributed to the hematogenous spread of cancer cells, which can travel through the bloodstream to these locations. The lungs are particularly susceptible because of their extensive vascular supply and the ability of cancer cells to lodge in the pulmonary capillary bed. Bone metastasis is also common, with the spine and pelvis being favored sites due to their rich blood supply and the presence of certain growth factors that support tumor growth. While other sites, such as the brain and liver, can also be involved in metastatic disease, they occur less frequently compared to lung and bone involvement. The abdomen and pelvis can contain other complications due to kidney cancer, such as retroperitoneal lymphadenopathy, but they do not represent the most common metastatic sites in the systemic spread of the disease. Understanding the typical pattern of metastasis helps guide surveillance and management strategies for patients diagnosed with kidney cancer.