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Introduction
  • Most common cancer of the bladder
    • most commonly in lateral or posterior walls of bladder base
    • can also occur in renal calyces, renal pelvis, and ureters
    • usually a multifocal disease with papillary histology
  • Risk factors
    • phenacetin
    • smoking 
    • aniline dyes
    • cyclophosphamide
    • beer consumption (nitrosamines)
    • Schistosoma hematobium
      • more commonly produce squamous cell carcinoma but can also produce TCC
Presentation
  • Symptoms
    • hematuria/dysuria 
Differential
  • Urethral cancer
    • if blood is present with urethral discharge think urethral cancer 
Evaluation

  • Intravenous pyelography (IVP) and cystoscopy 
  • Alternative modalities include ultrasonography and CT scan
  • CT urography is a relatively new technique producing images similar to IVP while also giving traditional CT images.
Prognosis
  • Improved prognosis with blood group antigen expression of the tumor
 

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