Renal & Bladder Cancer Flashcards
Wilms tumor (renal cancer) one of most common neoplasm of _______
Wilms tumor is one of most common neoplasm of young children (usually presents between 2-5 yrs)
most common malignant abdominal tumor in children
what is Wilms tumor histologically comprised of?
comprised of tissues that resemble normal fetal tissue
ex) blastemic, stromal or epithelial
Wilms tumor is associated with other _____________
congenital abnormalities such as; anividia (absence of the iris), hemihypertrophy (enlargment of one side of face or body) & others usually of gentiourinary system
several chromosomal abnormalities have been associated with wilms tumors, most significantly
WT1 on chr 11, encodes for transcription factor that is critical for kidney development 20% of wilms tumors will have this mutation
what are the presentations of WIlms tumor
- common presenting signs; large asymptomatic abdominal mass & hypertension
- some children present with abdominal pain & vomiting or both
- microscopic and gross hematuria is present in 17% -25%
what is the treatment of wilms tumor
- surgery, chemotherapy & sometimes radiation
- long term survival rates have increased to more than 60% for all stages and to 88%-98% for stages 1 through 4
what are the two major groups of renal cancer
- Wilms tumor
- Renal cell carcinoma
renal cell carcinoma is the _______ leading malignancy among men & ______ among women
6th
11th
Peak incidence of renal cell carcinoma
ages 55-84
what is the etiology of renal cell carcinoma
- unknown, correlations between heavy smoking & obesity particularly in women
- additional risk factors: occupational exposure to petroleum products, heavy metals & asbestos
what is the presentation of renal cell carcinoma
- silent in early stages
- symptoms usually indicate advanced disease ie) flank pain, hematuria, palpable flank mass
diagnosing renal cell carcinoma
ultrasound, CT, MRI
treatment of renal cell carcinoma
- surgery (radical nephrectomy with lymph node dissection-treatment of choice for all resectable tumors
- chemo limited success
- immunotherapy some success
- nephron sparing surgery may be done both kidneys invaded
- 5 year survival rate is 90% if tumor has not extended beyond the renal capsule, but drops to 30% if metastasis has increased
classification of renal cell carcinoma
- Clear cell carcinoma (60%)
- clear cytoplasm
- usually show chr 3 deletion - papillary tumors 5-10%
- chromophobic tumors 5-10%
- Oncocytomas 5-10%
- collecting duct tumors less than 1%
_______ cancer is most common cause of urinary tract cancer in Canada
bladder cancer
greater occurrence in _____
greater occurrence in men 4th in men, 8th women
90% of bladder cancers are derived from _________ cells that line the bladder
transitonal (urothelium)
tumors of the bladder fall into 2 categories
- low grade non-invasive
2. High grade invasive tumors that are associated with mestatasis & worse prognosis
Etiology of bladder cancer
- uknown
- carcinogens that are excreted in urine & stored in the bladder, include breakdown products of aromatic amines in dye industry, products of rubber, textiles, paints
- 30-50% associated with cigarette smoking
- chronic bladder infections & bladder stones also increase risk for bladder cacher
- bladder cancer more frequent among persons harbouring parasite schistosoma haematobium in their bladder (endemic in eygpt & sudan)
manifestations of bladder cancer
- painless hematuria happens in 75% of people
- frequency, urgency & dysuria occasionally accompany
- periodic urine cytology is recommended for people who are at risk for developing
diagnosing bladder cancer
- cytology studies
- excretory urogray (radiographic examination of urinary tract)
- cystoscopy & biopsy
- ultrasonography
- CT & MRI
treatment of bladder cancer
- depends on extent of lesion & health of pt
- endoscopic resection for superficial lesions
- external beam radiation
- chemotherapy-certain types can be instilled directly into bladder avoiding gross systemic effects
