MBBS OSCE · General Surgery / General Medicine
OSCE — Renal Cell Carcinoma
Eight-minute OSCE station on Renal Cell Carcinoma: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Renal Cell Carcinoma.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Renal cell carcinoma (RCC) is an adenocarcinoma arising from the proximal convoluted tubular epithelium and the commonest primary malignancy of the kidney (about 80 to 90 percent of all renal malignancies). Clear-cell RCC is the dominant subtype (about 75 percent) and is driven by bi-allelic inactivation of the VHL tumour-suppressor gene on chromosome 3p25, with consequent accumulation of hypoxia-inducible factor (HIF) and up-regulation of VEGF, PDGF, EPO, GLUT-1 and carbonic anhydrase IX. Established risk factors are smoking, obesity, hypertension, end-stage kidney disease with acquired cystic change, and the hereditary syndromes (Von Hippel-Lindau). Most tumours are now detected incidental
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | An incidental enhancing solid renal mass on CT or ultrasound — renal cell carcin |
| Safety | New-onset left varicocele, especially one that does not empty on lying down, in |
| Safety | The classic triad of haematuria, flank pain and a palpable flank mass — often in |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.