GUT: Bladder and Ureteric Tumours

Question 1

Are Transitional cell carcinomas invasive?

Answer 1

No, but have high recurrence rates and are therefore managed as carcinomas

Question 2

Risk factors for bladder cancer

Answer 2

Smoking
ANILINE DYE FROM RUBBER
Males
Hydrocarbons

Question 3

Presentation of bladder cancer?

Answer 3

LUTS (lower urinary tract symptoms)

Haematuria (micro or macro)

Rarely a mass lesion

Question 4

Investigations for bladder cancer?

Answer 4

Cystoscopy
Then CT or MRI

Biopsy or TURBT (transurethral rescetion of bladder tumour)

Question 5

What does bladder carcinoma in situ appear like on cystoscopy?

Answer 5

Red patches

Question 6

What does superficial TCC appear like on cystoscopy?

Answer 6

Polypoid papillary fronds projecting into bladder

Question 7

What does invasive TCC appear like on cystoscopy?

Answer 7

Ulceration and necrosis

Pale and flat

Question 8

Adenocarcinoma histology: Differs from TCC and SCC as it forms ____ structures. uncommon tumour seen at the __ of the bladder where it is see with persistent urachus or urachal remnants

Answer 8

Glandular

Dome

Question 9

How is bladder cancer staged?

Answer 9

From pta to pt4

Question 10

Describe the pTa stage

Answer 10

Superficial non invasive carcinomas, graded from I to III

Question 11

Describe the pT1 stage

Answer 11

Carcinoma has invaded submucosa

Question 12

Describe the pT2 stage

Answer 12

Carcinoma has invaded muscle coat

Question 13

Describe the pT3 stage

Answer 13

Carcinoma has gone beyond muscle coat

Question 14

Describe the pT4 stage

Answer 14

Tumour has entered prostate, uterine cavity or cervix

Question 15

Surgical treatment options for bladder cancer?

Answer 15

TURBT+/- BCG therapy

Partial cystectomy

Full cystectomy and ilieal conduit (stoma)

Question 16

Treatment of carcinoma in situ?

Answer 16

BCG therapy (intravesical immunotherapy drug)

Question 17

Most common type of renal pelvic/ureteric cancer?

Answer 17

Similar to bladder, TCC

Question 18

What is the quirk of a ureter TCC?

Answer 18

Often multifocal and bilateral in over 10%

Therefore investigate every area

Question 19

What percentage of patients with a ureter TCC will develop a bladder TCC?

Answer 19

Over 50% (this is a field change)