Lesson 4C (Part 2)

Question 1

Transitional Cell Carcinoma

Answer 1

Cancer that forms in the transitional cells in the lining of the bladder, ureter or renal pelvis

Question 2

TCC

Answer 2

Transitional Cell Carcinoma

Question 3

What is the nature of TCC? (2)

Answer 3

1. Multifocal

2. Bilateral

Question 4

Who is TCC more common in?

Answer 4

Men

- 65 years of age

Question 5

What is a symptom of TCC? (2)

Answer 5

1. Flank pain

2. Gross or microscopic hematuria

Question 6

What can fat within the renal sinus appear as?

Answer 6

A mass and simulate TCC

Question 7

What is necessary to confirm TCC? (2)

Answer 7

1. IVU

2. CT

Question 8

What does TCC look like on US? (3)

Answer 8

1. Discrete
2. Solid
3. Central hypoechoic renal sinus mass

Question 9

What are 3 differential diagnosis for TCC?

Answer 9

1. Blood clots
2. Sloughed papillae
3. Fungus balls

Question 10

What does TCC rarely invade?

Answer 10

The renal pelvis

Question 11

How much does ureteral TCC account for in all the upper urinary tract cancers?

Answer 11

1-6%

Question 12

Who is most affect by ureteral TCC?

Answer 12

Men

- 50-70 years of age

Question 13

What are the S/S of ureteral TCC? (4)

Answer 13

1. Hematuria
2. Frequency
3. Dysuria
4. Pain

Question 14

What is the sonographic appearance of ureteral TCC? (3)

Answer 14

1. Hydronephrosis
2. Hydroureter
3. Occasionally solid ureteral mass is seen

Question 15

What is necessary with ureteral TCC? (2)

Answer 15

1. IVU

2. Retrograde pyelography

Question 16

What is the most common malignant tumour?

Answer 16

Bladder TCC

Question 17

Who is most affect by bladder TCC?

Answer 17

Men

- 60-70 years of age

Question 18

What part of the bladder is affect by TCC? (3)

Answer 18

1. Trigone
2. Lateral walls
3. Posterior walls

Question 19

What are the S/S of bladder TCC? (4)

Answer 19

1. Hematuria
2. Frequency
3. Dysuria
4. Suprapubic pain

Question 20

What is easy to detect with a full bladder?

Answer 20

Detection of polypoid tumours

Question 21

What can help to demonstrate the vascular stalk (pedicle)?

Answer 21

Colour doppler

Question 22

What is necessary for the diagnosis of bladder TCC? (2)

Answer 22

1. Cystoscopy

2. Biopsy

Question 23

What does bladder TCC look like sonographically? (2)

Answer 23

1. Nonmobile focal mass ***

2. May calcify

Question 24

How do you tell if a mass can move or not?

Answer 24

Turn the patient into decubitus position

- if the mass moves its probably a clot

Question 25

What is the differential diagnosis of bladder TCC? (9)

Answer 25

1. Cystitis
2. Wall thickening
3. Postradiation change
4. Blood clot
5. Invasive prostatic carcinoma
6. Lymphoma
7. Metastasis
8. Endometriosis
9. Neurofibromatosis

Question 26

How much more common is bladder TCC compared to renal elvis TCC?

Answer 26

50x

Question 27

Why is bladder TCC more common compared to renal elvis TCC?

Answer 27

Due to its larger surface area

Question 28

Why is renal TCC 2-3X’s more common than ureteral TCC?

Answer 28

Because of its multifocal and bilateral nature

- may develop upper tract lesion when bladder TCC is apparent

Question 29

Bladder outlet obstruction

Answer 29

Blockage at the base of the bladder that reduces or prevents the flow of urine into the urethra

Question 30

What are the causes of bladder outlet obstruction? (4)

Answer 30

1. Enlarged prostate
2. Stones
3. Tumours
4. Scar tissue