Angiogenesis in Renal Cell Carcinoma: Molecular Biology, Clinical Manifestations, and Case-Based Insights | Chapter 7 | Newer Frontiers in Urology, Volume II

 

Angiogenesis is the defining biological feature of clear-cell renal cell carcinoma (ccRCC). Loss of Von Hippel–Lindau (VHL) function stabilises hypoxia-inducible factors (HIFs), upregulating vascular endothelial growth factor (VEGF) and allied mediators that produce a hypervascular, leaky, and fragile tumour vasculature. This chapter offers a concise, clinically oriented review of renal cell carcinoma (RCC) angiogenesis centred on an exceptional case: a right-sided ccRCC with intratumoral arteriovenous (AV) shunting and venous collaterals that communicated with the second part of the duodenum, presenting as severe upper gastrointestinal (GI) bleeding. We translate the mechanism into management, emphasising rapid stabilisation, diagnostic angiography, endovascular embolisation, and definitive surgery; then situate contemporary systemic therapy [VEGF/VEGF receptor (VEGFR) tyrosine kinase inhibitors (TKIs), immuno-oncology–TKI (IO–TKI) combinations, and HIF-2α inhibition] within decision frameworks that clinicians can apply. An expanded discussion links vessel biology to imaging signatures, resistance, perioperative strategies, and follow-up care. This case serves as a central framework for demonstrating how timely, multidisciplinary coordination can prevent catastrophic haemorrhage and ensure durable oncological control.

 

 

Author(s) Details

Rajan Ravichandran
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Roshan Reddy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Vivek Meyyappan
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH7

A Case Report on Subretinal Choroidal Neovascular Membrane | Chapter 2 | Current Practice in Medical Science Vol. 3

Older persons are more susceptible to the degenerative retinal condition known as subretinal choroidal retinal membrane. It results in the aberrant proliferation of vessels from the choriocapillaris through the Bruch membrane and into the region beneath the retina or the retinal pigment epithelium. One of the main indications of a macula problem is metamorphopsia. It is seen in disorders of the Bruch's membrane such as angioid streaks, pathological myopia, trauma, viral or inflammatory illnesses, and other pathologies. Based on how it appears on fluorescein angiography, it is classified as classic, occult, and mixed type. If there is no underlying reason for the neovascularization, the consequence is idiopathic choroidal neovascular membrane (CNV). In this example, the pathophysiology of the condition and available treatments are briefly described. It is known for self-contained, obvious regressive behaviour, and often has a favourable visual prognosis. Submacular bleeding is now being treated with anti-vascular endothelial growth factor (VEGF). The amount, position, and thickness of the bleed, however, all affect the visual prognosis.

Author(s) Details:

Rubina Shah,

King Edward Medical University Lahore, National Eye Center, Pakistan and FAAO American Academy of Optometry, National Eye Center Lahore, Pakistan.

Please see the link here: https://stm.bookpi.org/CPMS-V3/article/view/7380