Bladder Tumours Flashcards
where does urothelium line from
renal pelvis and calyces right down to urethra
what are the cells at the luminal surface of urothelium called
umbrella cells - domed surface
name 2 special properties of urothelium
- variability in the thickness of the cells represents different states of distension
- apical surface has a thickened membrane to provide a highly impermeable barrier
what are 90% of bladder tumours
TCC
risk factors for TCC
- Chemical exposure: aniline dyes, aromatic anines (rubber industry), cyclophosphamide
- Analgesics
- Smoking
- Male > female
what age are they most common
5th decade of life
presentation
- PAINLESS HAEMATURIA
- recurrent UTI
- voiding irritability
- general systemic features
which region of the bladder do most TCC occur in
trigone - can cause ureteric obstruction
papillary TCC
- superficial, mushroom like shape
- 80% TCC are these, 50% of these are infiltrative malignancies
carcinoma in situ - TCC
- very abnormal
- tend to grow quickly
- high grade
stage 0a and 0is
what stage is stromal and detrusor muscle invasion
recurrence of TCC?
- frequent, tumours often progress to a higher grade/stage
- screen with cytstoscopy at least once a year for those with previous cancer
investigations
- cystoscopy
- CT urogram provides staging
how may the appearance of papillary tumours be described
stippled
what proportion of bladder tumours do squamous ones make up
9%
how can SCC be caused
- calculi causing chronic irritation to the epithelial lining of the bladder, inflammation and then infection
- leads to metaplasia then SCC
risk factors for SCC
- schistosomiasis
- long term indwelling catheter
- renal stone
what developmental defect can lead to adenocarcinoma of the bladder
- extroversion - defect where part of the bladder and urethra are exposed, metaplastic changes lead to malignancy
embryonal rhabdomyosarcoma
the most common malignant bladder tumour in children, malignant cells resemble developing skeletal muscle of child
treatment of superficial cancer
transurethral resection of bladder tumour or local diathermy
treatment of cancer that has invaded into the detrusor muscle (T2)
radical cystectomy
