S11.1 Renal & Transitional Cell Carcinoma

Question 1

What is TCC and where is it found?

Answer 1

TCC is a cancer of the transitional epithelium and can be found in the kidney, ureter or bladder.

Question 2

Where is RCC found?

Answer 2

RCC is a cancer found in the kidney parenchyma

Question 3

Describe the presentation of RCC

Answer 3

Haematuria
High bp
Palpable mass in abdomen 
Large varicocele
Pulmonary embolism

Question 4

Describe the presentation of TCC

Answer 4

Haematuria
Weight loss
DVT

Question 5

What does histology for RCC show?

Answer 5

Clear cells full of glycogen

Question 6

Give some risk factors for RCC

Answer 6

Smoking

Obesity

Question 7

How can RCC spread?

Answer 7

Perinephric
Lymph node metastases
IVC spread into right atrium

Question 8

What is the treatment for localised RCC?

Answer 8

Surveillance
Excision (partial removal of kidney)
Ablation (complete removal)

Question 9

What is the treatment for metastatic RCC?

Answer 9

Cannot be cured so need biological therapies which target angiogenesis

Question 10

What are some risk factors for bladder TCC?

Answer 10

Smoking

Occupation: painter, coal miner

Question 11

What is the treatment for bladder TCC?

Answer 11

TUR bladder tumour (TURBT)

Question 12

What is seen on histology of the cells of bladder TCC?

Answer 12

Increased nuclear:cytoplasmic ratio

Pleomorphism

Question 13

Bladder TCC can be staged as superficial or muscle invasive, what is the treatment for each?

Answer 13

Superficial - cytoscopy

Muscle invasive - neoadjuvant (before surgery) chemo and radiotherapy

Question 14

What is the treatment for upper urinary tract TCC?

Answer 14

Nephro-uterectomy (removal of kidney, ureter and cuff of bladder)

Question 15

What things can cause squamous cell carcinoma (rare) of the bladder?

Answer 15

Stones
Schistomiasis
Recurrent bladder infections