leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
A. leiomyosarcoma
increase the irrigation fluid and pursue the procedure
abort the procedure and leave a urethral catheter
perform cystogram and manage accordingly
perform abdominal exploration and manage accordingly
multifocality
high tumor grade and advanced stage
presence of CIS
all of the above
obstructive LUTS are common presentations and occur in association with carcinoma in situ
might present as perineal abscesses and fistulae
could be asymptomatic
venereal diseases increase the risk of urethral cancers
never
unlikely
likely
always
sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
RB
cyclin A
HRAS
CD-44
often of high-grade sarcomas
often associated with muscularis propria invasion
due to vesical polyps occluding ureteric orifices
should be resected but not diathermized
obstructive uropathy
painless hematuria
pain radiating to the groin
locally advanced tumor
patients with carcinoma in situ
patients with completely resected solitary tumor
patients with preserved kidney and liver functions after 2 courses of BCG
patients with leiomyosarcoma
epirubicin
mitomycin c
BCG
none of the above
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
the standard treatment is transurethral resection
the prognosis for inverted papilloma is pathetic, with a recurrence rate of approximately 65%
the likelihood of synchronous urothelial carcinoma is 26%
has been shown to harbor p53 gene mutations
2%
5%
70%
90%
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
small cell carcinoma
nodular or sessile lesions usually invade muscle
papillary bladder tumors are typical of low stage and grade
carcinoma in situ appears as a flat, velvety patch
sarcomas commonly invade bladder base and ureteral orifices causing obstructions
2 - 4%
4 - 6%
6 - 8%
8 - 10%
cisplatin
BCG
mitomycin C
5-fluorouracil
the lesion is solitary and no associated CIS
physically, a surgical margin of 2-cm can be obtained
the resected area should be far enough from ureteral orifices and the bladder neck
all of the following
frequently found in association with high-grade or extensive TCC
has a rate of progression to muscle invasion of 10-25%
significant areas of CIS are easily missed by routine cystoscopy
treatment begins with TURBT
continue the procedure as perforations at this site do no harm
abort the procedure and leave a urethral catheter
convert tumor removal to open method and repair the defect
perform abdominal exploration and manage accordingly
there will be no target tumor tissue to work on
post-op. hematuria interacts unfavorably with BCG composition
of the risk of systemic absorption and sepsis
of the high risk of BCG reflux to kidneys while bladder irrigation
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
comparable
40 - 55%
55 - 70%
70 - 85%
85 - 100%
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
high specificity
high sensitivity
high reliability
strong validity
the anterior urethra drains into the inguinal and pelvic nodes
the posterior urethra drains into the pelvic nodes
the proximal two-thirds drain into the external and internal iliac nodes
the distal one-third drains into the obturator nodes
well-differentiated tumor with broad-based invasive font
marked atypia distributed on wide areas of superficial urothelium
atypia is present
no atypia but marked degenerative epithelial changes