Urology: Urinary Tract Neoplasms Flashcards
what is the triad found in advanced renal disease?
- loin pain
- flank mass
- haematuria
fluid investigations for neoplasms
- urinalysis (haematuria)
- CBC (anaemia, polycythaemia)
- creatinine
- LFTs
- calcium (high)
radiological investigations in neoplasms
- IVP
- ultrasound
- CT scan
- CXR
- bone scan
- angiography/cavogram
- renal biopsy (rare)
how can RCC spread?
- local infiltration
- lymphatic: local and distant nodes
- blood: lung, bone, liver
- venous: renal vein, IVC, atrium
what are the stages of RCC?
- Stage 1: confined to the kidney
- Stage 2: local invasion of capsule only
- Stage 3: local nodes or renal vein involvement
- Stage 4: distant metastasis
features of paraneroplastic syndromes
- hypercalcaemia
- polycythaemia
- hypertension
treatment of localised RCC
- radical nephrectomy in localised disease
- partial lobectomy for solitary lung metastasis
treatment of metastatic disease
- tyrosine kinase inhibitors
- radiotherapy
- immunotherapy
- hormonal therapy
histological types of testicular cancer
- non-seminomatous (embryonal cell carcinoma, teratoma, choriocarcinoma, yolk sac)
- seminoma
- secondary tumours
risk factors for testicular cancer
- undescended testicle
clinical presentation of testicular cancers
- painless mass in the testicle
- weight loss
- back pain
differential diagnosis to testicular cancer
- hydrocoele
- hernia
- epididymal cyst
- torsion
- epididymitis
tumour markers in testicular cancers
- beta HCG
- alpha-fetoprotein
why are tumour markers important?
- if elevated after cancer surgery, it indicates metastasis
- monitors the response to treatment and sensitive for indicating disease relapse
radiological investigations of testicular cancer
- US testes
- metastatic work up: CT chest, abdomen, pelvis
treatment for testicular cancer
- radical inguinal orchidectomy
- radiotherapy (seminomas are radiosensitive)
- chemotherapy (cisplastin-based)
staging of testicular cancer
Stage 1: limited to the testicle
Stage 2: enlarged lymph nodes below the diaphragm
Stage 3: enlarged lymph nodes above the diaphragm or extranodal metastatic deposits
what type of cancer is a penile cancer?
squamous cell carcinoma
where can penile cancer spread to?
inguinal and pelvic lymph nodes and then to other organs
risk factors for penile cancer
- not being circumcised
- Balanitis Xerotica Obliterans
- genital warts
staging of penile cancer
Stage 1: confined to glans or prepuce
Stage 2: invasion into shaft of penis/no lymph nodes
Stage 3: inguinal lymph node spread
Stage 4: distant metastasis
clinical presentation of penile cancer
- patchy erythema, ulceration, warty growth, extensive destruction of the penile tissue
- itch or burning in a non-retractile foreskin
- painless
diagnosis and staging of penile cancer
- biopsy of the lesion
- CT abdomen and pelvis
treament of penile cancer
- wide local excision
- circumcision, glansectomy, partial penectomy
- total penectomy and perineal urethrostomy
- inguinal lymphadenectomy, radiotherapy and chemotherapy
