泌尿生殖道肿瘤TUMORS OF GENITOURINARY TRACT.pptVIP

TUMORS OF GENITOURINARY TRACTYiran Huang  Department of Urology,  Renji Hospital, SSMU,  Renal cell carcinoma Renal cell carcinoma (RCC) is the most common type of kidney cancer. These tumors occur twice as often in men as in women and usually occur in adults between the ages of 50 and 70. Between 25 and 30% of patients have metastases at the time of diagnosis. Environmental risk factors include smoking , Phencetin-containing painkillers abused or over-used, some heavy metals exposure ( lead and cadmium).  Other risk factors include long-term dialysis, overweight, a high fat diet. There are also hereditary risk factors. There are some genes mutations in rare syndromes like tuberous sclerosis and von Hippel Lindau Disease that are associated with an increased risk of developing kidney tumors. Types of renal cell carcinoma:Clear cell RCC (60 to 75 percent), papillary RCC (15 percent), chromophobe RCC (5 percent), collecting duct carcinoma (less than I percent), and unclassified carcinoma (up to 5 percent).  Clinical Presentation1. Renal cell carcinoma can become quite large without causing any symptoms. Many tumors are found incidentally. 2. Hematuria is the most common symptom. Other signs and symptoms include low back pain, a mass in the abdomen,  There are multiple imaging studies, including intravenous pyelogram (IVP), ultra-sonography, computerized tomographic (CT) scans, magnetic resonance imaging (MRI) which can produce images of the kidney.  Arteriography and angiography can demostrate blood vessels and image the kidney. A chest x-ray is used to evaluate the lungs metastases. A bone scan can identify cancer in bone. Staging of Renal Cell Carcinoma Stage Ⅰ cancer is confined to the kidney,  Stage Ⅱ means the cancer has broken through the kidney capsule and has spread into adjacent tissue,  Stage Ⅲ indicates that it may have spread further into lymph nodes or blood vessels,  Stage Ⅳ indicates th