UTUC (Chap 98 12th ed)

Question 1

What is the substance behind Balkan and UTUC in Taiwan?

Answer 1

aristocholic acid

Question 2

What syndrome is linked to familial UTUC?

Answer 2

Lynch syndrome aka HNPCC

Question 3

What medication is related to pelvic and ureteral tumors?

Answer 3

Analgesic abuse

Question 4

Benign lesions of the upper tracts

Answer 4

Papillomas, inverted papillomas, and Brunn’s nests are usually
benign lesions.

Question 5

Symptoms of localized and advanced UTUC?

Answer 5

Localized disease: hematuria, dysuria, and flank pain.

Advanced disease: flank or abdominal mass, weight loss, anorexia,
bone pain

Question 6

Imaging with highest diagnostic accuracy in UTUC?

Answer 6

CT urography

Question 7

Where are UTUC most commonly found?

Answer 7

Ureteral tumors are in the distal ureter in 70% of cases, midureter in
25% of cases, and upper ureter in 5% of cases. Bilateral disease
occurs in 3% to 5% of cases.

Question 8

How does UTUC spread?

Answer 8

Disease spread: direct expansion of the tumor, lymphatics, and blood
stream.

Question 9

What are the predictors of worse prognosis and recurrence?

Answer 9

Ureteral and/or multifocal tumors have a worse prognosis than renal
pelvic tumors.

Muscle-invasive tumors have poor prognosis.

Positive regional LNs have poor survival prognosis.

Lymphovascular invasion is a predictor of disease recurrence and
survival.