Lesson 4C (Part 2) Flashcards
Transitional Cell Carcinoma
Cancer that forms in the transitional cells in the lining of the bladder, ureter or renal pelvis
TCC
Transitional Cell Carcinoma
What is the nature of TCC? (2)
- Multifocal
2. Bilateral
Who is TCC more common in?
Men
- 65 years of age
What is a symptom of TCC? (2)
- Flank pain
2. Gross or microscopic hematuria
What can fat within the renal sinus appear as?
A mass and simulate TCC
What is necessary to confirm TCC? (2)
- IVU
2. CT
What does TCC look like on US? (3)
- Discrete
- Solid
- Central hypoechoic renal sinus mass
What are 3 differential diagnosis for TCC?
- Blood clots
- Sloughed papillae
- Fungus balls
What does TCC rarely invade?
The renal pelvis
How much does ureteral TCC account for in all the upper urinary tract cancers?
1-6%
Who is most affect by ureteral TCC?
Men
- 50-70 years of age
What are the S/S of ureteral TCC? (4)
- Hematuria
- Frequency
- Dysuria
- Pain
What is the sonographic appearance of ureteral TCC? (3)
- Hydronephrosis
- Hydroureter
- Occasionally solid ureteral mass is seen
What is necessary with ureteral TCC? (2)
- IVU
2. Retrograde pyelography
What is the most common malignant tumour?
Bladder TCC
Who is most affect by bladder TCC?
Men
- 60-70 years of age
What part of the bladder is affect by TCC? (3)
- Trigone
- Lateral walls
- Posterior walls
What are the S/S of bladder TCC? (4)
- Hematuria
- Frequency
- Dysuria
- Suprapubic pain
What is easy to detect with a full bladder?
Detection of polypoid tumours
What can help to demonstrate the vascular stalk (pedicle)?
Colour doppler
What is necessary for the diagnosis of bladder TCC? (2)
- Cystoscopy
2. Biopsy
What does bladder TCC look like sonographically? (2)
- Nonmobile focal mass ***
2. May calcify
How do you tell if a mass can move or not?
Turn the patient into decubitus position
- if the mass moves its probably a clot
What is the differential diagnosis of bladder TCC? (9)
- Cystitis
- Wall thickening
- Postradiation change
- Blood clot
- Invasive prostatic carcinoma
- Lymphoma
- Metastasis
- Endometriosis
- Neurofibromatosis
How much more common is bladder TCC compared to renal elvis TCC?
50x
Why is bladder TCC more common compared to renal elvis TCC?
Due to its larger surface area
Why is renal TCC 2-3X’s more common than ureteral TCC?
Because of its multifocal and bilateral nature
- may develop upper tract lesion when bladder TCC is apparent
Bladder outlet obstruction
Blockage at the base of the bladder that reduces or prevents the flow of urine into the urethra
What are the causes of bladder outlet obstruction? (4)
- Enlarged prostate
- Stones
- Tumours
- Scar tissue
