TUMOR SALURAN KEMIH

(TUMORS/MALIGNANCY OF
URINARY TRACT)
Dr.M.Galuh Richata, SpU
TUMORS OF THE URINARY
TRACT
Kidney
Ureter
Bladder
Prostate
Urethra (very rare)
External Genital (penis & testicular)
KIDNEY TUMORS
Tumor from the Parenchyma:
- Renal Cell Carcinoma (most kidney tumor in
adults)
- Nephroblastoma / Wilms Tumor (in
children)
Tumor of the Epithelium:
Urothelium Tumor of the Renal Pelvis (=
Urothelium Tumor of Urinary Tract)
KIDNEY TUMORS
Presentation:
Triad of classic signs & symptoms
- Palpable mass (40%)
- Flank pain (40%)
- Hematuria (60%)
all exist only 10-15%
KIDNEY TUMORS
Presentation
Sign/symptoms secondary to metastases:
Lung dyspnea, cough
Brain seizure, headache
Bone bone pain
KIDNEY TUMORS
Presentation
Paraneoplastic Syndrome:
- Erythrocytosis
- Hypercalcemia
- Hypertension
- Nonmetastatic hepatic dysfunction
KIDNEY TUMORS
Imaging
USG, IVP/IVU, CT Scan, MRI
Intervention
Mostly surgical, depends on the staging
(TNM)
Prognosis: poor
5 year survival rate : 50% (overall)
70% if no metastases
15-20%, if renal vein involved
TUMORS OF UROTHELIUM
From the urothelial lining of the urinary tract
( the transitional cells)
transitional tumor / transitional cell
carcinoma
May arise anywhere in the urinary tract, but
predominantly in bladder (then in renal
pelvis/calices >> ureter >> urethra)
BLADDER CANCER
Transitional Cell Carcinoma (TCC) of the
bladder
Squamous Cell Carcinoma (Epidermoid) of
the bladder
Adenocarcinoma of the bladder
Rhabdomyosarcoma of the bladder
Etc
TRANSITIONAL CELL CARCINOMA

Peak incidence: 50 70 years old

Men : women = 3 : 1
Risk factor:
Smoking
Chemical exposure: Aromatic hydrocarbons
Chronic irritation/inflammation: stone, worm,
infection
Radiation exposure
TRANSITIONAL CELL CARCINOMA
Sign & Symptoms
Hematuria : about 80% gross hematuria

Classic symptom: recurrent-painless

hematuria.
Dysuria and irritative symptoms (30%)
Upper urinary tract obstruction (advanced
disease)
TRANSITIONAL CELL CARCINOMA
Diagnosis
Imaging : USG, IVU, CT scan, MRI

Urine cytology
TRANSITIONAL CELL CARCINOMA
Cystoscopy
 TRANSITIONAL CELL CARCINOMA
Clinical Stage
TRANSITIONAL CELL CARCINOMA
Intervention
Surgery (Endoscopic, Cystectomy)
Chemotherapy
Radiation
TUMORS OF URINARY TRACT
Every patients with
hematuria must be
suspected as a patient
with malignancy,
until it is proven otherwise
GENETIC AND CONGENITAL DISEASE
OF URINARY TRACT
Disorders of the:
Kidney
Ureter
Bladder
Urethra & Genitalia
DISORDERS OF THE KIDNEY
Agenesis (mostly unilateral; bilateral very rare)
Hypoplasia
Supernumerary
Simple Cyst
Multicystic Kidney
Polycystic Kidney Disease
DISORDERS OF THE KIDNEY
Renal Fusion (horse shoe kidney)
Ectopic Kidney
Abnormal Rotation
DISORDERS OF THE URETER
PUJO (PelvioUreteral Junction Obstruction)
VesicoUreteral Reflux
Ectopic Ureteral Orificium
Double Collecting System
Ureterocele
DISORDERS OF THE BLADDERS
Extrophy Bladder
Persistent Urachus
Contracture of the Bladder Neck
DISORDERS OF URETHRA &
GENITALIA
Urethral Stricture
Posterior Urethral Valve
Hypospadia
Epispadia
Priapism
Phimosis
Paraphimosis