Urinary tract cancer most commonly involves the bladder, although it may also occur in the renal pelvis, ureters, and, rarely, the urethra.

Epidemiology

• Cancer sites
  • Bladder (90%)
  • Renal pelvis and renal calyces (8%)
  • Ureter and urethra (2%)
• Histological types
  • Transitional cell (urothelial) carcinoma: most common (∼ 95%) type of cancer of the bladder, ureter, renal pelvis, and proximal urethra in male individuals
  • Squamous cell carcinoma: most common (∼ 60%) type of cancer of the distal urethra in male individuals and the entire urethra in female individuals

Risk factors

Transitional cell urothelial carcinoma

• Carcinogens
  • Tobacco (esp. due to 2-naphthylamine in cigarette smoke)
  • Aromatic amines (e.g., benzidine, aniline dye, azo dye, arylamines)
  • Medications
    • Cyclophosphamide
    • Phenacetin
    • High-dose, long-term pioglitazone treatment [11]
  • Heavy metals (e.g., chlorine and arsenic content in drinking water)

Pathology

• Papillary urothelial carcinoma
  • A thick papilla with a fibrovascular core
• Squamous cell carcinoma
  • Chronic inflammatory stimuli (e.g., schistosomiasis, chronic cystitis) can lead to transformation of urothelial cells into squamous epithelial cells (squamous metaplasia)

Clinical features

Diagnostics

Treatment