Imaging the urinary tract: cancers Flashcards
Prostate cancer presentation
asymptomatic unless advanced
How is a prostate biopsy done?
transrectal and transperineal ultrasound-guided
How do prostate cancer metastases look on xray?
sclerotic (due to osteoblastic activity)
If you incidentally detect osteoblastic (sclerotic) lesion on a plain radiograph in an elderly male, what is it until proven otherwise?
prostate cancer (metastases)
Top 4 primaries that metastasise to bone
breast
lung
prostate
kidney
How might bone metastases present?
pain
cauda equina/cord compression
Prostate cancer treatment
active surveillance
radiotherapy
prostatectomy
hormone therapy (anti-androgens)
Where to RCCs like to spread to?
renal vein
How do RCCs often look on CT?
heterogenous lesion
necrotic centre (hypoattenuated)
Where do RCCs often metastasise to?
lungs
bone (lytic lesions)
liver
Name some malignant renal tumours
RCC (renal cell carcinoma)
TCC (transitional cell carcinoma)
Wilms tumour
Lymphoma
Metastasis (rare)
Name some benign renal tumours
angiomyolipoma
oncocytoma (look like RCCs so are often removed)
When should angiomyolipomas be removed?
> 4cm as bleeding risk
Which condition is associated with developing angiomyolipomas?
tuberous sclerosis
What is the commonest location of a transitional cell carcinoma?
bladder (arise in urothelium)
How does transitional cell carcinoma present?
haematuria
What 2 tests should be done to investigate haematuria?
USS urinary tract (look for kidney cancer)
cystoscopy (look for bladder cancer)
If you haven’t found a cause of haematuria after USS urinary tract and cystoscopy, where should you look next?
ureters
When can cystectomy be used to treat bladder cancer?
if MRI shows no invasion of cancer out of bladder (must be able to see clear area all around the bladder on MRI)
How are testicular cancers imaged?
USS
What tumour markers could be present in non-seminoma germ cell tumour of the testicles?
AFP
HCG
LDH
What is an orchiectomy?
a surgical procedure to remove one or both testicles
How are tumour markers used in testicular cancer?
usually checked before and after orchiectomy
monitor patient’s treatment response and to detect recurrence
Where is the sentinel node in testicular cancer?
below renal vein (only pelvic organ that doesn’t affect pelvic lymph nodes first)
