{"id":103,"date":"2018-04-06T10:29:09","date_gmt":"2018-04-06T07:29:09","guid":{"rendered":"http:\/\/www.leonsaporta.com\/en\/?p=103"},"modified":"2018-05-02T15:36:17","modified_gmt":"2018-05-02T12:36:17","slug":"ureter-kanserleri","status":"publish","type":"post","link":"http:\/\/www.leonsaporta.com\/en\/ureter-kanserleri\/","title":{"rendered":"Ureter Cancers"},"content":{"rendered":"

RENAL PELVIS AND URETER TUMORS<\/strong><\/p>\n

They consist of 5 to 10% of renal tumors. It is more common in men, at and over 65 years and it may be bilateral in 2 to 4% of the cases.<\/p>\n

\"\"<\/p>\n

ETIOLOGY (CAUSE)<\/strong><\/p>\n

As well as it has not any exact cause;<\/p>\n

Smoking \u2013 long use of some analgesic drugs such as phenacetin \u2013 long use of a drugs called cyclophosphamide which is used for chemotherapy \u2013 chronic urinary tract infection- stones not treated for a long period \u2013 diseases that cause obstruction in urinary tract \u2013Balkan nephropathy are among causes.<\/p>\n

PATHOLOGY<\/strong><\/p>\n

90% of them is originated from transitional cells which spread the inner layer of urinary tract like bladder tumors (TCC: transitional cell carcinoma). Squamous epithelium cell cancer (ca) is 10% of the cases and the cause is stones in general. There is adenocarcinoma less then 1% and stone and infection accompany to it.<\/p>\n

\"\"<\/p>\n

At the diagnosis 30% of renal pelvis tumors are high grade and 65% of them were located on renal pelvis.<\/p>\n

70% of ureter tumors are detected on distal ureter. While patients with bladder tumor have a risk of tumor development on upper urinary system is: 2 to 4%, Patients with renal pelvis and ureter tumor have a risk of bladder tumor development is 30 to 75%.<\/p>\n

Metastasis are most common on: Lymph glands \u2013 Lung- Liver and Bones.<\/p>\n

Staging and grading are most important criteria to determine the prognosis. Multifocality is seen in high grade tumors and indicates bad prognosis.<\/p>\n

CLINICAL PICTURE AND DIAGNOSIS<\/strong><\/p>\n

Nonspecific findings for the tumor type such as PAINLESS MACROSCOPIC HEMATURIA WITH 80%, Abdominal Pain- Weight loss \u2013 Nausea\/Vomiting- Anemia.<\/p>\n

DIAGNOSIS<\/strong><\/p>\n

All painless hematuria cases should be approached by a concern that there is an underlying tumoral event unless otherwise is proven.<\/p>\n

Ultrasonography (US) and\/or Urography (IVP) should be performed first. US: It may show a mass within the renal pelvis or images on enlargement on the upper side due to a mass in the ureter may be taken. IVP: It may show a filling defect and non functioning in the kidney.<\/p>\n

\"\"\"\"<\/p>\n

COMPUTED TOMOGRAPHY (CT) :<\/strong><\/p>\n

It may show both renal pelvis and mass in the ureter as well as it is a test that should be preferred to show metastasis on surrounding tissues.<\/p>\n

\"\"<\/p>\n

URETEROSCOPY is a test that may be applied to see the inner side of the ureter clearer for bleedings without undetected reason.<\/p>\n

Furthermore<\/strong> : Retrograde pyelography \u2013 cytology and cystoscopy may be done.<\/p>\n

 <\/p>\n

STAGING<\/p>\n

To : No tumor detected<\/p>\n

Tx : Primary tumor can not be determined<\/p>\n

Tis : Carcinoma in-situ<\/p>\n

T1 : Papillary non-invasive carcinoma<\/p>\n

T2 : Tumor metastatic to the muscle<\/p>\n

T3 : Peripelvic or periurethral soft tissue or renal parenchyma involvement<\/p>\n

T4 : Adjacent organs involvement<\/p>\n

N : Regional lymph nodes<\/p>\n

No : No significant lymph node could be detected by clinical evaluation.<\/p>\n

N1 : Metastasis < 2cm in the lymph node.<\/p>\n

N2 : Metastasis between 2 and 5 cm in the lymph node or metastasis <5 cm on multiple lymph nodes.<\/p>\n

N3 : Metastasis >5 cm in the lymph node.<\/p>\n

 <\/p>\n

M: Distant metastasis<\/p>\n

Mo : No distant metastasis<\/p>\n

M1 : Distant metastasis<\/p>\n

TREATMENT<\/strong><\/p>\n

Nephroureterectomy (removal of the kidney + ureter + the area where the ureter enters from the bladder) is an ideal therapy. This procedure may be performed with open surgery as well as Laparoscopic surgery.<\/p>\n

Conservative approaches (Endoscopic resection \u2013 tumor excision and end to end anastomosis to the ureter or neocystostomy i.e.) may be tried for low grade and stage tumors.<\/p>\n

Chemotherapy and\/or Radiotherapy may be tried for metastatic cases.<\/p>\n","protected":false},"excerpt":{"rendered":"

RENAL PELVIS AND URETER TUMORS They consist of 5 to 10% of renal tumors. It is more common in men, at and over 65 years and it may be bilateral in 2 to 4% of the cases. ETIOLOGY (CAUSE) As well as it has not any exact cause; Smoking \u2013 long use of some analgesic […]<\/p>\n","protected":false},"author":1,"featured_media":104,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kidney-ureter"],"_links":{"self":[{"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/posts\/103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/comments?post=103"}],"version-history":[{"count":5,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/posts\/103\/revisions"}],"predecessor-version":[{"id":599,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/posts\/103\/revisions\/599"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/media\/104"}],"wp:attachment":[{"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/media?parent=103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/categories?post=103"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.leonsaporta.com\/en\/wp-json\/wp\/v2\/tags?post=103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}