eMedicine Specialties > Radiology > Genitourinary

Transitional Cell Carcinoma: Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, UK
Coauthor(s): Hemalatha Chandramohan, MBBS, Staff Physician, Department of Geriatric Medicine, Stepping Hill Hospital, United Kingdom; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute; Lalam Radhesh Krishna, MBBS, MRCS, Specialist Registrar, Department of Radiology, North Manchester General Hospital; Tufail Ahmed Patankar, MBBS, FRCR, PhD, DMRD, DMRE, DNBE, Consulting Neuroradiologist and Interventional Neuroradiologist, Department of Neuroradiology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust; Rizwan Ahmed Malik, MBBS, MA, Specialist Registrar, Department of Radiology, Manchester Training Scheme, Royal Bolton Hospital, UK
Contributor Information and Disclosures

Updated: Jun 10, 2008

Intervention

Nephrostomy may be indicated in cases of inoperable renal or ureteric neoplastic obstruction or as a stop-gap procedure before surgery to improve renal function. The conventional, standard technique in the treatment of TCC is a nephroureterectomy with either a standard surgical technique or a laparoscopic approach. Percutaneous renal endoscopy has been used in the diagnosis and treatment of TCC affecting the renal collecting system; however, this approach remains controversial.

In high-risk patients and in those with a solitary kidney, a less invasive approach may be considered. A percutaneous nephrostomy tract is created to access the tumor, which is then removed by use of a resectoscope with electrocautery or an Nd:YAG laser.23,24

Special Concerns

  • Although percutaneous nephrostomy is successful for the removal of most tumors of the renal collecting system, the recurrence rate is high, and nearly one third of patients have recurrent tumors within 2 years.
  • Because of these serious limitations, the percutaneous method is reserved for high-risk patients with a solitary low-grade lesion of the kidney, a negative history of bladder TCC, and negative preoperative cytologic results in the upper urinary tract.
  • Unlike renal cell adenocarcinomas, TCC is prone to spread after percutaneous interventional procedures (eg, nephrostomy).
 


More on Transitional Cell Carcinoma

Overview: Transitional Cell Carcinoma
Imaging: Transitional Cell Carcinoma
Follow-up: Transitional Cell Carcinoma
Multimedia: Transitional Cell Carcinoma
References
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References

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Further Reading

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Keywords

TCC, transitional cell carcinoma in situ, uroepithelial tumors, epithelial tumor of the bladder, papillary carcinomas, grade 1 papillary carcinomas, nonpapillary carcinomas

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, UK
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, British Medical Association, British Society of Interventional Radiology, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Hemalatha Chandramohan, MBBS, Staff Physician, Department of Geriatric Medicine, Stepping Hill Hospital, United Kingdom
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Lalam Radhesh Krishna, MBBS, MRCS, Specialist Registrar, Department of Radiology, North Manchester General Hospital
Disclosure: Nothing to disclose.

Tufail Ahmed Patankar, MBBS, FRCR, PhD, DMRD, DMRE, DNBE, Consulting Neuroradiologist and Interventional Neuroradiologist, Department of Neuroradiology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust
Tufail Ahmed Patankar, MBBS, FRCR, PhD, DMRD, DMRE, DNBE is a member of the following medical societies: British Society of Neuroradiologists and Royal College of Radiologists
Disclosure: Nothing to disclose.

Rizwan Ahmed Malik, MBBS, MA, Specialist Registrar, Department of Radiology, Manchester Training Scheme, Royal Bolton Hospital, UK
Disclosure: Nothing to disclose.

Medical Editor

Steven Perlmutter, MD, FACR, Associate Professor of Clinical Radiology, School of Medicine at Stony Brook University; Medical Director of Radiology, Peconic Bay Medical Center
Steven Perlmutter, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Association of Program Directors in Radiology, Association of University Radiologists, Medical Society of the State of New York, Radiological Society of North America, Society of Breast Imaging, Society of Nuclear Medicine, and Society of Uroradiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Joshua A Becker, MD, Professor, Department of Radiology, New York University School of Medicine
Joshua A Becker, MD is a member of the following medical societies: Society of Uroradiology
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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