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Ureteral & Renal P elvis Tumor

Ureteral & Renal P elvis Tumor. INCIDENCE. rare, only 4% bladder : renal pelvis : ureter = 51 : 3 : 1 mean age : 65 세 male : female = 2-4 : 1. Characteristics. patients with single upper tract carcinoma 1) at risk of developing

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Ureteral & Renal P elvis Tumor

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  1. Ureteral & Renal Pelvis Tumor

  2. INCIDENCE • rare, only 4% • bladder : renal pelvis : ureter = 51 : 3 : 1 • mean age : 65 세 • male : female = 2-4 : 1

  3. Characteristics • patients with single upper tract carcinoma 1) at risk of developing bladder cancer : 30-50% 2) at risk of developing contralat. upper tract cancer : 2-4% • primary bladder cancer • at risk of developing upper tract ca. : < 2 %

  4. Etiology • Smoking • Industrial dyes or solvents • Analgesics abuse: Balkan nephropathy • Thorotrast: RGP에 쓰는 조영제

  5. Pathology • Transitional cell ca. • renal pelvis tumor (90%) • ureteral cancer (97%) common meta. Sites: LN, bone, lung • Squamous cell ca. • Adenocarcinoma • Fibroepithelial polyps

  6. Sx & Signs • gross hematuria (70-90%) • flank pain (8-50%) • irritative voiding symptoms (5-10%) • flank mass or tenderness (10-20%)

  7. Lab. findings • urine cytology • barbotage cytology • ureteral brush biopsy

  8. X - ray findings • IVP: filling defect, NVK, hydronephrosis • RGP: Goblet sign • US • CT • MRI

  9. IVP of renal pelvis tumor

  10. RGP of renal pelvis tumor

  11. Staging of renal pevis & ureter tumor

  12. DDx • Nonopaque calculi • Blood clots • Papillary necrosis • Inflammatory lesions: Tbc, • ureteritis cystica, fungus infection

  13. Ureteropyeloscopy:direct visualization • Indication • evaluation of filling defect • after positive results on cytology • unilateral gross hematuria • surveillance

  14. Treatments • Nephroureterectomy with bladder cuff excision • Distal ureterectomy & reimplantation • Open & endoscopic procedure • Cisplantin - based chemotherapy

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