The main symptom of urothelial carcinoma?

summary

Urothelial tumors of the upper urinary tract are rare. According to foreign reports, renal pelvic tumors account for about 10% of all renal tumors and 5% of all urothelial tumors. Bilateral tumors were rare, and upper urinary tract epithelial tumors occurred simultaneously or successively in 2% ~ 5%. Ureteral tumor is only 1 / 4 of renal pelvis tumor. Renal pelvic carcinoma accounts for 24% - 26% of renal tumors. The ratio of male to female was 3 ∶ 1, with an average age of 56.4 years (range, 17-80 years). The main symptom of urothelial carcinoma? Let's talk about it

The main symptom of urothelial carcinoma?

Intermittent hematuria, gross hematuria is the most common symptom (40% ~ 70%), most of the whole course hematuria, with strip blood clot. Microscopic hematuria can be found in almost all patients. When severe obstruction occurred, the upper urinary tract was dilated, and the contrast medium density was decreased or not developed. The contralateral upper urinary tract and bladder should be carefully observed. Retrograde upper urography can be performed in patients with poor development, and cytological examination can be performed with flushing solution.

About 1 / 3 of patients with low back pain complained of blunt pain due to upper urinary tract obstruction and dilatation. Blood clots passing through the ureter can cause renal colic. About 10% ~ 15% of the patients had no special symptoms, and the upper urinary tract tumor was found only when imaging examination was performed for other reasons. A small number of patients because of abdominal, waist mass, weight loss, anorexia and other symptoms.

The accuracy of urine cytology examination with excreted urine is low, and most of the tumors with low tumor grade have no abnormal findings. The positive rate increased with tumor grade. After ureteral intubation, normal saline was used to wash the ureter repeatedly, and the reflux liquid was collected for cytological examination, which can improve the diagnosis rate.

matters needing attention

Drug infusion therapy has been reported in the literature for the treatment of lower ureteral carcinoma with vesicoureteral reflux. After tumor resection, the upper urinary tract perfusion therapy with thiotepa or BCG and perfusion therapy for upper urinary tract carcinoma in situ can also obtain some curative effects. But some patients complicated with sepsis, renal pelvis, ureteral scar formation and obstruction, and systemic toxicity caused by drug absorption. Although there are few reports of serious complications, the safety of this treatment is still questionable. This method may be most suitable for patients with multiple superficial tumors of upper urinary tract or carcinoma in situ, poor renal function or bilateral tumors. It is better to drip drugs through nephrostomy tube than retrograde perfusion.