TUMOR SALURAN KEMIH

(TUMORS/MALIGNANCY OF
URINARY TRACT)

Dr.M.Galuh Richata, SpU

TUMORS OF THE URINARY

TRACT

Kidney
Ureter
Bladder
Prostate
Urethra (very rare)
External Genital (penis & testicular)

KIDNEY TUMORS

Tumor from the Parenchyma:

- Renal Cell Carcinoma (most kidney tumor in
adults)
- Nephroblastoma / Wilms Tumor (in
children)
Tumor of the Epithelium:
Urothelium Tumor of the Renal Pelvis (=
Urothelium Tumor of Urinary Tract)

KIDNEY TUMORS

Presentation:
Triad of classic signs & symptoms
- Palpable mass (40%)
- Flank pain (40%)
- Hematuria (60%)
all exist only 10-15%

KIDNEY TUMORS

Presentation
Sign/symptoms secondary to metastases:
Lung dyspnea, cough
Brain seizure, headache
Bone bone pain

KIDNEY TUMORS
Presentation
Paraneoplastic Syndrome:
- Erythrocytosis
- Hypercalcemia
- Hypertension
- Nonmetastatic hepatic dysfunction

KIDNEY TUMORS

Imaging
USG, IVP/IVU, CT Scan, MRI
Intervention
Mostly surgical, depends on the staging
(TNM)
Prognosis: poor
5 year survival rate : 50% (overall)
70% if no metastases
15-20%, if renal vein involved

TUMORS OF UROTHELIUM

From the urothelial lining of the urinary tract

( the transitional cells)
transitional tumor / transitional cell
carcinoma
May arise anywhere in the urinary tract, but
predominantly in bladder (then in renal
pelvis/calices >> ureter >> urethra)

BLADDER CANCER

Transitional Cell Carcinoma (TCC) of the

bladder
Squamous Cell Carcinoma (Epidermoid) of
the bladder
Adenocarcinoma of the bladder
Rhabdomyosarcoma of the bladder
Etc

TRANSITIONAL CELL CARCINOMA

Peak incidence: 50 70 years old

Men : women = 3 : 1
Risk factor:
Smoking
Chemical

exposure: Aromatic hydrocarbons

Chronic irritation/inflammation: stone, worm,
infection
Radiation exposure

TRANSITIONAL CELL CARCINOMA

Sign & Symptoms
Hematuria : about 80% gross hematuria
Classic symptom: recurrent-painless
hematuria.
Dysuria and irritative symptoms (30%)
Upper urinary tract obstruction (advanced
disease)

TRANSITIONAL CELL CARCINOMA

Diagnosis
Imaging : USG, IVU, CT scan, MRI

Urine cytology

TRANSITIONAL CELL CARCINOMA

Cystoscopy

TRANSITIONAL CELL CARCINOMA

Clinical Stage

TRANSITIONAL CELL CARCINOMA

Intervention
Surgery (Endoscopic, Cystectomy)
Chemotherapy
Radiation

TUMORS OF URINARY TRACT

Every patients with

hematuria must be
suspected as a patient
with malignancy,
until it is proven otherwise

GENETIC AND CONGENITAL DISEASE

OF URINARY TRACT
Disorders of the:
Kidney
Ureter
Bladder
Urethra & Genitalia

DISORDERS OF THE KIDNEY

Agenesis (mostly unilateral; bilateral very rare)

Hypoplasia
Supernumerary
Simple Cyst
Multicystic Kidney
Polycystic Kidney Disease

DISORDERS OF THE KIDNEY

Renal Fusion (horse shoe kidney)

Ectopic Kidney
Abnormal Rotation

DISORDERS OF THE URETER

PUJO (PelvioUreteral Junction Obstruction)

VesicoUreteral Reflux
Ectopic Ureteral Orificium
Double Collecting System
Ureterocele

DISORDERS OF THE BLADDERS

Extrophy Bladder
Persistent Urachus
Contracture of the Bladder Neck

DISORDERS OF URETHRA &

GENITALIA

Urethral Stricture
Posterior Urethral Valve
Hypospadia
Epispadia
Priapism
Phimosis
Paraphimosis