Bladder cancers

Posted by e-Medical PPT Wednesday, July 7, 2010
The vast majority of bladder cancers are transitional cell tumours.(arising from transitional cells of the mucosal urothelium) Adenocarcinoma accounts for approximately 2%. Squamous cell tumours usually follow chronic inflammation from stones or indwelling catheters.Leiomyosarcoma is the most common sarcoma of the bladder whilst rhabdomyosarcoma is most common in children.In developed countries, about 90% of bladder tumours are transitional cell carcinoma with 5% squamous cell carcinoma; however, in developing countries, 75% are squamous cell carcinoma, mostly due to schistosomiasis.
Risk factors are Heavy Smoking,Industrial exposure to aromatic amines in dyes( beta naphthylamine), paints, solvents, leather dust, inks, combustion products, rubber and textiles,Environmental pollution, e.g. arsenic-contaminated wells
Genetic predisposition,Radiation to the pelvis and Cyclophosphamide.
The presenting feature is painless haematuria that is gross in 80 to 90%. There is usually no abnormality on standard physical examination. Painless haematuria must be treated as malignancy of the urinary tract until proved otherwise. This includes clear cell carcinoma of the kidney. Advanced disease may cause voiding symptoms, although these can even be produced by carcinoma in situ.

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