Urological Tumours Flashcards
What is the group of NSGCT?
- Teratomas
- Teratocarcinomas
- Embryonic carcinomas
- Choriocarcinomas
- Yolk sac carcinomas
What is the histological subtypes of Renal Cell Carcinoma
- clear cell carcinoma
* papillary
What are the benign types of RCC
- oncocytoma
- adenoma
- angiomyolipoma
What is scleropathy
Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins. Sclerotherapy involves an injection of a solution (generally a salt solution) directly into the vein. The solution irritates the lining of the blood vessel, causing it to collapse and stick together and the blood to clot.
What are the benign types of RCC
- oncocytoma
- adenoma
- angiomyolipoma
Risk factors for RCC
Von Hippel Landau disease
Smoking
Obesity (70% of them are obese
What is the local spread of RCC?
Gerotas fascia
Adrenals
Posterior Abdominal Wall
What are the different types of malignant Renal Cell Ca?
Urothelial and Parenchymal
Which part of the prostate does prostate cancer originate from?
Peripheral zone
Which part of the prostate does BPH originate from?
Transitional zone
Name 5 causes of penile cancer:
- Presence of foreskin
- Balanitis xerotica obliterans
- Leukoplakia(white plaques)
- HPV
- Condylomata acuminata
What is BXO?
Balanitis Xerotica Obliterans is the presence of white plaques on the foreskin/glans
It often involves the urethral meatus and can cause strictures
Associated with the development of penile cancer
What are the type of cells associated with the pathology of penile cancer?
90% Squamous cell carcinoma
Sometimes basal cell or melanoma
What does penile squamous cell look like macroscopically
Exophytic, cauliflower(fungating appearance)
Ulcerating with round edges
Where does penile cancer locally spread to?
Glans, foreskin, urethra, penile shaft, bucks fascia
What is the lymphatic spread of penile cancer?
- Early spread is the superficial and deep inguinal nodes
2. Advanced- the inguinal lymph nodes and skin and possibly the femoral vessels
What is the most common place for mets to be located in penile cancer?
Lung mets
What is a more rare variant of penile carcinoma
Verrucous carcinoma-associated with extensive penile warts and Rx is surgery to the penile lesion
How do you diagnose penile cancer?
Do a biopsy of the penile lesion-ring block at base of penis and excise
If the penile lesion is not responding to STI Rx after 4 weeks
If the lesion is becoming worse(more ulcerating and fungating)
If you palpate hard, mobile or fixed inguinal LN
How do you treat penile cancer?
Depends on the involvement:
- Foreskin-circumsicion
- Glans/distal shaft-partial penectomy
- Proximal shaft- total penectomy and perineal urethrostomy
- small lesions treated with External beam or brachytherapy
What is the 5 year prognosis of penile CA
Iliac node involvement- 0%
When can you not operate on LN in penile cancer?
When skin is involved or they involve femoral vessels(catarostrophic haemmorhage)
Is the urethral cancer more common in men or women?
It is more common in women
What types of pathologies are in urethral CA?
squamous cell carcinoma
transitional cell carcinoma
adenocarcinoma
Urethral CA Dx
IS made by examination-cytoscopy and visible growth in the urethra
How many stages are there for Prostate cancer?
4
What 3 modalities do we base the risk stratification on?
PSA, Digital rectal exam and Gleason score
What are the long term side effects of a radical prostatectomy?
Bleeding, Erectile Dysfunction, and long term incontinence
What is removed during a radical prostatectomy?
The prostate, seminal vesicles and Lymph Nodes
What are the management options for intermediate risk Prostate Ca?
- Radical prostatectomy
2. Radiotherapthy- External Beam and Brachytherapy
How do you treat Spinal cord compression?
With ketoconazole or dexamethesone
How do you treat High Risk prostate Ca patients?
First do bone scan and MRI to exclude mets
If no mets-do radical prostatectomy
If mets-do ADT mainly BO in TBH
If not use LHRH
What are LHRH analogues?
Zoludex with anti-androgen to prevent flair
