Neoplasms of the Urinary Tract

Question 1

Where are most tumors of the urinary tract located?

Answer 1

bladder

Question 2

Are urinary tract cancers more common in men or women?

Answer 2

Men

Question 3

bladder cancer is what percentage of total cancer?

Answer 3

7%

Question 4

what is the male to female predominance of bladder cancer?

Answer 4

3:1

Question 5

What is the most common tumor type in bladder cancer?

Answer 5

urothelial (transitional) tumors - 90%

Question 6

What is the most important risk for bladder cancer?

Answer 6

cigarette smoking

Question 7

What are some other exposure risk factors for bladder cancer besides smoking?

Answer 7

exposure to aryl amines (industrial) long term analgesic use heavy cyclophosphamide exposure schistosoma haematobium irradiation

Question 8

What is the clinical presentation of bladder cancer?

Answer 8

• painless hematuria (but also sign in non-tumor lesions of the bladder)
• irritative symptoms (frequency, urgency, dysuria)
• hydronephrosis (when ureteral orifice involved)

Question 9

How is bladder cance diagnosed?

Answer 9

• urine examination
  
  • microsocpic exam
  • FISH analysis
• cystoscopy
  
  • washings/tissue biopsy

Question 10

what is another name for urothelium?

Answer 10

transitional epithelium

Question 11

What are the two precusor lesions to bladder cancer?

Answer 11

• noninvasive papillary tumors (mc)
  
  • may progress to invasive carcinoma (different histologic grades)
  • cauliflower-like
  • fibrocascular core with cells coming off of it
• noninvasive flat carcinomas (carcinoma in situ)
  
  • always severe atypia/high grade
  • almost always progress to invasive carcinoma

Question 12

What is the standard treatment for bladder cancer that invades the muscle wall?

Answer 12

cystectomy

(surgical removal of bladder)

Question 13

What is the grading system for bladder tumors?

T1-T4

Answer 13

T1 - lamina propria invasion

T2 - muscularis propria invasion

T3 - extravesical fat invasion

T4 - invasion into adjacent structures/organs

Question 14

Renal cell carcinoma are ____ of all newly diagnosed cancers in the U.S.

Answer 14

3%

(85% of adult renal cancers)

Question 15

What is the male:female ratio of renal cell carcinoma?

Answer 15

2:1

Question 16

What percentage of renal carcinoma is clear cell carcinoma?

Answer 16

70-80%

Question 17

What is the most common mutation in renal cell carcinomas?

Answer 17

Von Hipple Lindau gene deletion on chromosome 3p

Question 18

What does clear cell renal carcinoma look like pathologically?

Answer 18

• round cells with abundant clear cytoplasm (fat and glycogen)
• delicate branching vasculature (chicken-wire)

Question 19

what is the cure rate for wilms tumor?

Answer 19

approximately 90%