Renal Cell Carcinoma

The gross specimen of a kidney shown above demonstrates a large, multi-nodular mass with a predominantly yellowish-orange cut surface, interspersed with areas of hemorrhage and necrosis. What is the most likely diagnosis?

A 58-year-old man with a 10-year history of chronic kidney disease presents with hematuria and a 4 cm renal mass on imaging. Histopathology reveals clear cell renal cell carcinoma with Fuhrman nuclear grade 2. Which of the following is NOT a characteristic feature of clear cell RCC?

A 62-year-old woman with metastatic renal cell carcinoma progresses on sunitinib after 8 months of treatment. She has good performance status and no significant comorbidities. What is the drug of choice for second-line therapy?

A 62-year-old man with a 10-year history of hypertension is found to have a 4 cm renal mass on imaging. Staging workup is initiated. Which is the most common site of metastatic spread in renal cell carcinoma?

A 58-year-old man with stage IV renal cell carcinoma (clear cell type) with pulmonary and bone metastases presents for systemic therapy. He has no prior systemic treatment. What is the drug of choice for first-line treatment?