July 1st, 2015
Urothelial tumors are tumors that involve the urinary system. They are found in the renal pelvis, the urinary bladder, ureters and the urachus. The ureteral tumors are the most common of the urothelial tumors while the tumors of the renal pelvis account for just 5% of all Urothelial tumors.
In the western world, the incidence of urothelial tumors is two per 100,000 people. The mean age for getting affected by this type of tumor is 65 years. Urothelial tumors of renal pelvis and ureters (upper tract Urothelial tumor) are more common in males with the male to female ratio of incidence being 3:1.
60% of the urothelial tumors of the upper tract are invasive in nature.
95% of all upper tract urothelial tumors are transitional cell carcinomas. Squamous cell carcinomas constitute 1% to 7% of these tumors and are usually associated with staghorn calculi. Adenocarcinomas constitute less than 1% of urothelial tumors.
The WHO staging is based on the aggressiveness of the tumor. It can be papillary urothelial neoplasia, low grade carcinoma or high grade carcinoma.
The TNM classification is based on the extent of spread of tumor.
Patients with low grade superficial lesions are ideal candidates for segmental ureterectomy and endoscopic therapy.
Nephro-ureterectomy with excision of bladder cuff is indicated in case of renal pelvis urothelial tumors with
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