Urologic neoplasms Flashcards
Renal cell carcinoma
the most common type of kidney cancer in adults
RCC epidemiolgy
northern european ancestry and north americans > asian or african descent
RCC pathophysiology
originates proximal renal tubular epithelium. some hereditary syndromes: VHL, HPRC, BHDS, HRC
RCC signs and symptoms
classic triad of flank pain, hematuria, and flank mass (10% pts) weight loss, fever, htn, hypercalcemia, night sweats, malaise, varicocele
RCC diagnosis labs
UA, CBC with diff, electrolytes, renal profile, LFTs, calcium, ESR, PT, aPTT
RCC imaging
ultrasound, CT ab and pelvis, CXR, CT chest and MRI to assess IVC mets
treatment of RCC
radical nephrectomy
- removal of kidney, ipsilateral renal gland and regional lymph nodes
- partial nephrectomy
- laproscopic nephrectomy
- radiofrequency heat ablation or cryoablation
RCC management
SURGERY-remains the only known effective tx for localized RCC radiation therapy chemo hormonal therapy immunotherapy combo therapy palliative therapy in advanced disease
Bladder cancer epidemiology
common urologic ca
highest recurrence rate of any malignancy
most common type is transitional cell carcinoma
Risks for bladder cancer
SMOKING MOST COMMON
male
>65 y.o
signs and symptoms of bladder cancer
painless gross hematuria irritative bladder sxs-dysuria, urgency, frequency pelvic or bony pain lower extremity edema flank pain palpable mass
bladder ca labs
UA with micro UC voided urinary cytology urinary tumor marker testing fluroescence in situ hybridization (FISH) may improve accuracy of cytology
bladder ca imaging/procedures
cystoscopy-primary modality for dx of bladder carcinoma permits biopsy and resection of papillary tumors.
upper urinary tract imaging
hematuria workup
CT pelvis and abdomen
bladder ca diagnostic strategy with negative cystoscopy
negative UC and FISH-routine f/u
negative UC, postive FISH-increased frequency of survey
positive UC and +/- FISH cancer until proven otherwise
bladder ca treatment
surgery-TURBT/cystectomy/cystoprostatectomy
chemo
immunotherapy