12.9 Lower Urinary Tract Carcinoma

Question 1

Urothelial Carcinoma

Answer 1

Malignant tumor arising from urothelial lining of the renal pelvis, ureter, bladder or urethra

Question 2

What is the most common location of urothelial carcinoma?

Answer 2

Bladder

Question 3

What is the main risk factor for urothelial carcinoma?

Answer 3

Smoking

Question 4

Outside of smoking, what are other risk factors for urothelial carcinoma?

Answer 4

• Azo dyes
• Long term cyclophosphamide
• Phenacetin

Question 5

What is the classic presentation of urothelial carcinoma?

Answer 5

Painless hematuria

Question 6

What are the 2 pathways that can lead to urothelial carcinoma?

Answer 6

• Flat

- Papillary

Question 7

What is the progression of papillary urothelial carcinoma?

Answer 7

Low Grade to High Grade to Invasion

Question 8

What is the progression of flat urothelial carcinoma?

Answer 8

High Grade to Invasion

Question 9

What mutation is the flat pathway of urothelial carcinoma associated with?

Answer 9

Early p53 mutations

Question 10

What must occur before squamous cell carcinoma of the lower urinary tract occurs?

Answer 10

Squamous Metaplasia - normally there is no squamous tissue

Question 11

What are the risk factors for squamous cell carcinoma of the urothelium?

Answer 11

• Chronic cystitis
• Schistosome heatobium
• Longtime nephrolithiasis

Question 12

What does adenocarcinoma of the bladder generally arise from?

Answer 12

Urachal Remnant