Urothelial cancer Flashcards
Renal cell carcinoma epidemiology
Most common renal tumour in adults
>40y
Males
2% of malignancies
Renal cell carcinoma pathology
Adenocarcinoma Arises from renal tubules Usually well encapsulated Metastasise via lymph and blood to liver lung and bone Highly vascularised Very rarely benign
Renal cell carcinoma clinical features
Haematuria Loin pain, aching with intermittent acute Mass Malaise Anorexia Wt loss Polycythaemia Hypertension Pyrexia Mets
Renal cell carcinoma para neoplastic syndrome
Increased ESR Anaemia Polycythaemia Hypercalciemia Increased ALP Pyrexia Increased BP Amyloid deposition Peripheral neuropathy and myopathy
Renal cell carcinoma managment
Radical nephrectomy
Palliative embolisation
Radio/chemo ineffective
Nephroblastoma
What
Symptoms
How
Wilms tumour Undifferentiated embryonic tumour Failure to thrive Visible abdo mass 1/3 haematuria Mets in liver, lungs, bones, brain
Radical nephrectomy +- radio/chemo
Carcinoma of the renal pelvis
What
Symptoms
How
10% of renal tumours 90% derived from transitional epithelium 25% bilateral and associated with other urothelial tumours Loin pain and haematuria Remove kidney and ureter
Polycystic kidney disease What Symptoms Who How
Autosomal recessive -> 1st 9m of life -> Abdo distension -> die AD-> x10 more common Cysts in other organs Increased BP Polycythaemia Berry aneurysms 25-50y Loin pain Haematuria
-> USS-> requires dialysis and transplant
Transitional cell carcinoma of the bladder epidemiology
Transitional cell 50x more common in the bladder >40y M:F 5:1 80% low grade Can be in situ
Transitional cell carcinoma of the bladder risk factors
Smoking
Industrial carcinogens-> chemical, cable, rubber
Drugs
Chronic inflammation-> schistosomiasis
Transitional cell carcinoma of the bladder clinical features
Painless haematuria
UTI symptoms without bacteria
Local nerve pain
Lower Abdo pain
Severe dysuria
Incontinence
Transitional cell carcinoma of the bladder investigations
Urine microscopy and culture Urine cytology U and E's Flexible cystoscope and DRE USS and CT CXR and bone scan Biopsy
Transitional cell carcinoma of the bladder management
Radical resection and random biopsies Radical radiotherapy +\- chemo Radical cystoprostatectomy Life long surveillance 50% recurrence
