10. Carcinoma Of The Kidney And Bladder Flashcards
Where does renal cell carcinoma present?
Parenchyma of kidney
Where does transitional cell carcinoma present?
Anywhere from calyx to bladder
What are the risk factors for renal cell carcinoma?
Dialysis
Smoking
Obesity
Who is RCC more common in?
Male:female 3:1
60-70 year olds
What is the presentation of RCC?
Haematuria
Fatigue, weight loss, fever
May have mass in loin
If advanced, hypercalcaemia, large varicocele
Why can patients with RCC present with hypercalcaemia?
Some RCC can secrete hormone like substances such as PTH, causing hypercalcaemia
What are the investigations for RCC?
Radiology - CT or ultrasound
Endoscopy - flexible cystoscopy
Urine - cystology
What is the treatment for localised RCC?
Surveillance
Increasingly small tumours removed with partial nephrectomy to preserve some renal function
For large tumours with no distant metastases, radical nephrectomy with removal of associated adrenal gland, perinephric fat, upper ureter and para-aortic lymph nodes
What is the treatment for metastatic RCC?
Little effective treatment
Chemotherapy and radiotherapy resistant
Palliative treatment
What is the presentation of transitional cell carcinoma?
Haematuria
Incidental finding on imaging
Weight loss, loss of appetite
Signs/symptoms fo obstruction
What is the most common form of transitional cell carcinoma?
Bladder
What can bladder TCC be caused by?
Analgesic misuse
Exposure to aniline dyes used in industrial manufacture of dyes, rubber and plastics
Smoking
How can bladder TCC be diagnosed and treated?
Transurethral resection of bladder tumour (TURBT)
What are most bladder TCC?
Superficial
What are the treatment option for bladder TCC?
Low risk non-muscle invasive - TURBT +/ intravascular chemotherapy to bladder
High risk non-muscle invasive - TURBT + intravesical chemotherapy, intravesical BCG treatment, cystectomy
Muscle invasive cancer - cystectomy + radiotherapy or palliative care
