Carcinoma of the Kidney and Bladder Flashcards
Compare location of Renal Cell and Transitional Cell Carcinomas (RCC and TCC)
RCC;
- In parenchyma of kidney
TCC;
- Anywhere from Minor Calyx to Bladder
Describe the incidence of RCC
- 90% of renal malignant tumours in adults
- Arise from tubular epithelium
- Rare in children, mostly in 60-70s
- Male: Female ratio of 3:1
List 3 risk factors for RCC
Dialysis
Smoking
Obesity
How does RCC present?
Do they metastasise before or after local symptoms develop?
- 90% with Haematuria
- Vague symptoms (Fatigue, fever, weight loss)
- Possible mass in loin
- Before (Other kidney, bones, lungs etc)
How can advanced RCC present?
- May secrete hormone like substances such as PTH-rP
- Large varicocele may present
How can RCC be investigated?
- USS
- CT
- Flexible cystoscopy
- Urine Cystology (Uncommon)
How can localised RCC be treated?
- Monitoring
- Small tumours: Removal by partial nephrectomy
- Large tumours: Radical nephrectomy with removal of associated adrenal gland, perinephric fat, upper ureter and para-aortic lymph nodes
How can Metastatic RCC be treated?
Palliative treatment as it is resistant to chemo and radio-therapy
How does TCC present?
- Haematuria (as does RCC)
- Weight loss, appetite loss
- Signs of obstruction
Suggest 3 causes of Bladder TCC
(Male: Female of 3:1)
How can it be diagnosed and treated?
- Smoking
- Analgesic misuse
- Exposure to aniline dyes used in manufacture of dyes, rubber, plastics
- Transurethral Resection of Bladder Tumour (TURBT)
Patients with TCC of upper urinary tract have what % chance of leading to bladder cancer
How are upper urinary tract TCCs treated?
40%
Nephro-ureterectomy (Remove kidney, fat, ureter, some of bladder)
Why is it important to include muscle on a bladder biopsy?
Most important prognostic factor for bladder cancer
