1、膀 胱 肿 瘤（TUMORS OF THE BLADDER）Transitional cell carcinoma account for 90%The most common tumor of urologic tract in China The second most common of urologic tract in USGeneral ConsiderationsPathologyGrade-well differentiation with low malignancyGrade-moderate differentiationwith moderate malignancyG
2、rade-poor differentiationwith high malignancy TNM stage Tis-carcinoma in situTa-papillary noninvasivecarcinomaT1-not beyond the lamina propriaT2a-invasion of superficial muscleT2b-invasion of deep muscleT3-invasion through the bladder wallT4a-invading prostate,uterus,vaginaT4b-fixed to the pelvic wa
3、ll infiltrating the abdominal wall Muscle invasiveNonmuscle invasiveClinical Findings Symptoms and Signs1.Gross or microscopic hematuria2.Urinary frequency and urgency 3.PainClinical Findings Laboratory Findings 1.Microscopic hematuria2.Azotemia and anemia3.Cytological examinationClinical Findings I
4、maging Studies 1.Intravenous urography2.Ultrasonography 3.CT scan4.MRIClinical Findings Urinary Cytologic Studies Positive rate is not high especially in low grade tumorEndoscopic Findings Should detect nearly all tumors BiopsyClinical Findings Rigid cystoscopyFlexible cystoscopyClinical Findings Ri
5、ght ureteral orifice Left ureteral orificeClinical Findings Bubbles at the bladder dome D-J stentClinical Findings Transitional cell carcinomaClinical Findings Nutrient vessel of tumor Clot on the tumorClinical Findings Necrosis and calcification AdenocarcinomaTreatmentTreatment and prognosis of bla
6、dder tumorsTreatment1.Transurethral Resection,Fulguration,Laser TherapyTreatment2.Partial cystectomyRemoval of the tumor and a 2cm surrounding margin of normal bladderTreatment3.Radical cystectomy and pelvic lymph node dessectionExtent of surgical resectionTreatmentAccompany urinary diversionUreterostomyIleal conduitTreatmentOrthotopic ileal neobladderTreatment4.Radiotherapy and Chemotherapy
