Renal and bladder cancer
Which cells do most bladder cancers derive from?
Transitional (urothelium) cells that line the bladder
What kind of tumours do bladder cancers have? (in relation to grade)
Range from low-grade to high-grade tumours that invade the bladder wall and metastasize frequently
What are the other manifestations of bladder cancer?
- frequency - urgency - dysuria
How do you treat renal cell carcinoma?
- sx (radical nephrectomy with lymph node dissection) - nephron sparing sx if both affected - chemo
What are the manifestations of Wilms Tumours?
- HTN - abdominal pain and/or vomiting - hematuria
What congenital anomalies are associated with Wilms Tumours?
- aniridia (absence of the iris) - hemihypertrophy (enlargement of one side of the face or body) - and others; usually genitourinary
What are the 5 types of renal cell carcinoma?
- clear cell carcinoma - papillary tumours - chromophobic tumours - oncocytomas - collecting duct tumours
What is a embryonic kidney tumour also known as?
Wilms Tumour
Can Wilms Tumours present in both kidneys simultaneously?
Yes
How do you treat bladder cancer?
- depends on extent of lesions and health of patient - endoscopic resection - diathermy (ex. electrocautery) - segemental sx resection - cystectomy with resection of pelvic lymph nodes is tx of choice when invasive - radiation - intravesical chemo
What are the characteristics of clear cell carcinoma?
- clear cytoplasm - chromosom 3 deletion - from proximal tubular epithelial cells
How do you diagnose bladder cancer?
- cytologic studies - excretory urography - cysctoscopy - biopsy
What are the risk factors for renal cell carcinoma?
- heavy smoking - obesity (especially in women) - occupational exposure: petroleum products, heavy metals, and asbestos - acquired cystic kidney disease associated with chronic renal insufficiency
How do you diagnose Wilms Tumour?
- mother usually finds tumour while bathing - CT scan confirms diagnosis
How do you diagnose renal cell carcinoma?
- presentation - CT - US - MRI if inferior vena cava involvement suspected
What are the manifestations of renal cell carcinoma?
- silent tumour --> late manifestations and detection - hematuria - flank pain - presence of palpable flank mass
What does Wilms Tumour look like?
- solitary mass - well-defined borders - variably encapsulated-
What are the risk factors of bladder cancer?
- suggested to be r/t carcinogens excreted in urine and stored in the bladder - smoking - chronic bladder infections - bladder stones - people harbouring parasite Schistosoma haematobium in bladder
How do you treat Wilms Tumour?
- sx - cryotherapy - sometimes radiation
What is the most common renal cell carcinoma?
Clear cell carcinoma
Describe high-grade tumours
Easily progress to invasive stage.
What is a Wilms tumour composed of?
Elements that resemble normal fetal tissue: blastemic, stromal, and epithelial.
What are the two types of renal cancer?
Embryonic kidney tumours and renal cell carcinoma
What is the most common sign of bladder cancer?
Hematuria
What is the etiology of bladder cancer?
Idiopathic
Describe low-grade tumours
May recur after resection but also have an excellent prognosis.Very little progress to high-grade tumours.
Do men or women get bladder cancer more often?
Men
Screening of bladder cancer
People who are at high risk d/t exposure to urinary tract carcinogens are recommended to get periodic urine cystology. - flow cytometry is another tool
How do you identify the stages of bladder cancer?
US, CT, and MRI
What is the etiology of renal cell carcinoma?
Unclear
Who do Wilms Tumours affect?
Young children, usually presents between 3 and 5 years of age.
