Tumor Of The Genitourinary Tract

Tumors of urogenital system

Wu Yudong M.D. 武玉东 Dept. of Urology, the First Teaching Hospital of Zhengzhou University

Tumors of urogenital system

Most common: Second :

Bladder cancer

Renal cell carcinoma

ADENOCARCINOMA OF THE KIDNEY

ADENOCARCINOMA OF THE KIDNEY (RENAL CELL CARCINOMA) 1. Location: parenchyma of kidney 2. Histological types: Origin from renal tubule cells Most are clear cell carcinoma

RENAL CELL CARCINOMA

3. Passages of metastasis: Direct extension: renal vein Blood metastasis: brain, bone, liver, lung Lymphatic metastasis: lymph node of kidney

Symptoms 50~ 60 years old, male/female is 2/1 Three major symptoms: 1. Hematuria: invade pelvis 2. Mass: tumor large enough 3. Pains: dull pain

Symptoms

Diagnosis 1. Symptoms: Hematuria, mass, pains 2. IVP: Calices and pevis are compressed and distortion 3. CT and B ultrasound: Mass in parenchyma

IVP

CT

Treatment 1. Radical nephrectomy: kidney, fascia, fat and lymph nodes around kidney 2. Embolization of kidney: before operation, make it easy to be resected

Treatment

Tumor of renal pelvis ❂ Transitional cell carcinoma:

most common ❂ Squamous cell carcinoma:

Cause: irritation of stone infection

Tumor of renal pelvis

Symptoms and diagnosis 1. 40~70 years of age, male/female ratio is 2:1 2. symptom: intermittent painless gross hematuria 3. IVP: filling defect of pelvis

IVP

Symptoms and diagnosis 4. Cystoscopy: bleeding from ureteral orifice 5. Urine cytology: cancer cells 6. B ultrasound and CT:

CT

Treatment Operation: Resection extent : Kidney, Ureter and Partial bladder wall around ureteral orifice

Treatment

Bladder cancer

Bladder cancer ❂ The most common tumor of urinary

system ❂ Histology:

Transitional cell carcinoma

Bladder cancer ❂ Differentiation:

Grade I: low malignancy Grade II: middle malignancy Grade III: high malignancy

Bladder cancer Growth modes: Carcinoma in situ Papillocarcinoma Invasive carcinoma Location: lateral wall and back wall

Growth modes

Clinical stages of bladder cancer

Symptoms ❂ 50~70 years of age,

male/ female is 4:1

❂ Hematuria:

intermittent, painless

❂ Late stage:

difficult urination, urgency,

retention of urine

Diagnosis ❂ History and symptoms ❂ cystoscopy: ❂ IVP:

mass

filling defect of bladder; if there is tumor in ureter and pevis

❂ CT and ultrasound

Cystoscopy

Cystoscopy

CT

Treatment Operations: 1. Transurethral resection of bladder tumor: ( TUR-BT ) 2. partial cystectomy: at lest 2 cm around tumor

3. Total cystectomy

TUR-BT

Chemotherapy: Instillation of bladder Drugs: BCG thiotepa Mitomycin Pirarubicin

Operations

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