Cancer of a mochetochnik
Cancer of a mochetochnik – the malignant new growth coming from a mucous membrane of a mochetochnik or resulting from distribution of cancer cells from other body (usually – from a kidney lokhanka). It is shown by a gematuriya, pains in lumbar area and sharp temperature increase of a body in the evening. In the subsequent anemia develops, violations of an urination are possible. At an obturation of a gleam of a mochetochnik arises . The diagnosis "cancer of a mochetochnik" is exposed taking into account a clinical picture, given to ultrasonography, KT, a nefroskopiya, a tsistoskopiya, to a biopsy of a tumor and other researches. Treatment quick in combination with chemotherapy and radiotheraphy.
Cancer of a mochetochnik
Cancer of a mochetochnik – the rare malignant tumor affecting one or both mochetochnik. Happens primary or secondary. In 68% of cases it is localized in the lower departments, in 20% strikes an average third of body, in 9% settles down in the top departments, in 2% extends on all mochetochnik. With an identical frequency it is diagnosed on the right and at the left, in 2-4% of cases it is found in both mochetochnik. Men suffer mainly. In 80% of cases cancer of a mochetochnik comes to light at the age of 40-70 years.
Primary malignant new growths of a mochetochnik make from 1 to 4% of total of oncological defeats of the top uric ways. Secondary cancer of a mochetochnik usually results from implantation metastasis of cancer of a kidney lokhanka. Existence proksimalno of the located tumor of uric ways sharply increases probability of malignant process in the lower departments of an urinary system. Almost at a half of patients with cancer of a mochetochnik in the subsequent bladder cancer develops. At multifocal defeats the risk of emergence of a malignant new growth of a bladder increases to 70%. Treatment is performed by experts in the field of oncology and urology.
Reasons of cancer of a mochetochnik
The epithelium of uric ways is very sensitive to various harmful effects: chemical, mechanical, stagnant, inflammatory etc. Among the negative chemical factors increasing risk of development of cancer of mochetochnik – smoking (is the reason of formation of the products of tryptophane having cancerogenic activity), continuous contact with nitrobiphenyl, aminobiphenyl, a diaminodiphenyl, naphthylamine, benzidine, arsenic and some other substances.
The probability of developing of cancer of a mochetochnik at smokers directly correlates with an experience of the smoker and quantity of daily smoked cigarettes. The continuous contact with arsenic and other connections usually belongs to the category of professional vrednost though also exceptions are possible. In particular, arsenic can contain in water, some other substances – in the atmosphere of ecologically adverse areas. Experts consider that the high level of environmental pollution explains higher frequency of cancer of mochetochnik at citizens in comparison with villagers.
Among other factors provoking development of cancer of a mochetochnik – an urolithic disease and inflammatory diseases of uric ways. Moving ahead on uric ways, concrements cause constant irritation of a mucous membrane that leads over time to its giperplaziya. Inflamed or giperplazirovanny mucous becomes more vulnerable to effect of carcinogens. An additional negative role is played by stagnation of urine at which time of contact mucous with harmful chemical compounds increases.
Besides, among risk factors of development of cancer of a mochetochnik oncologists specify arterial hypertension (both primary, and caused by other diseases) and long reception of diuretics. It is established that at the patients having close relatives with cancer of a mochetochnik and tumors of a kidney lokhanka, this pathology develops more often than on average on population, however the probability of developing of a disease in similar cases increases slightly.
Classification of cancer of a mochetochnik
The tumor of a mochetochnik can be primary or secondary. Primary new growth develops directly from an epithelium of body, secondary results from implantation of the malignant cages migrating with urine current from a kidney lokhanka. The secondary cancer of a mochetochnik which developed as a result of the remote metastasis of tumors of other localizations is diagnosed seldom. Cancer of mochetochnik often happens multifocal (to simultaneous or almost simultaneous emergence of several centers of a malignization). If the center one – a new growth is considered single if a little – that multiple.
Taking into account features of a histologic structure allocate three types of cancer of a mochetochnik: planocellular, perekhodnokletochny and adenocarcinoma. In most cases (92-99%) experts diagnose perekhodnokletochny cancer. Planocellular tumors come to light at 1-8% of patients. Adenocarcinomas meet extremely seldom. Besides, cancer of a mochetochnik differs on degree of a differentiation of cages. There are four groups: the high-differentiated, moderately differentiated, low-differentiated and undifferentiated new growths.
One more indicator defining medical tactics and the forecast at malignant defeats of a mochetochnik is prevalence of oncological process. Cancer of a mochetochnik can be local, regionarny or with metastasises. The local new growth does not go beyond a mochetochnik, regionarny cancer of a mochetochnik sprouts nearby bodies, periuretralny, perirenalny or peripelvikalny cellulose, affects lymphatic vessels and regionarny lymph nodes. At cancer with metastasises secondary tumors in other bodies come to light.
Symptoms and diagnosis of cancer of a mochetochnik
The gematuriya becomes the reason of the first address to the doctor usually. Blood in urine and pain in lumbar area on the party of defeat at early stages are observed approximately at a half of patients with cancer of a mochetochnik. In the subsequent the gematuriya becomes more expressed, the repeating blood losses lead to anemia. Obturation of a gleam of a mochetochnik the growing tumor provokes and renal gripes. At some patients violations of an urination come to light.
One more characteristic symptom of cancer of a mochetochnik is temperature increase to febrilny figures in the evening. For the rest displays of a disease are similar to other oncological defeats. Patients with cancer of a mochetochnik lose appetite, suffer from weakness and bystry fatigue. In the started cases the kakheksiya, sharply expressed anemia and symptoms of defeat of various bodies caused by hematogenic metastasis join.
Cancer of a mochetochnik is diagnosed on the basis of clinical symptomatology and data of additional inspection. The program of inspection includes KT of a kidney, ultrasonography of a kidney, a kidney angiography developed and the cytologic analysis of urine and other researches. The most informative diagnostic techniques at cancer of a mochetochnik are the excretory urography and a retrograde ureteropiyelografiya (in the presence of contraindications appoint an antegradny piyelografiya) and a tsistoskopiya.
At a tsistoskopiya find the opukholevidny education acting from the mouth of a mochetochnik. Releases of blood are in certain cases visible. Radiological researches with contrasting allow to define localization of cancer of a mochetochnik, to see expansion of a lokhanka and the top departments of a mochetochnik, and also to distinguish (at his existence). On retrograde ureterogramma the characteristic picture of "language of a snake" caused by flowing of contrast substance on both parties of a tumor is looked through. The final diagnosis is exposed taking into account data of a histologic research of material.
Treatment and the forecast at cancer of a mochetochnik
Treatment is quick. At the small, low located tumor a mochetochnik delete together with a part of a bladder, form . At widespread cancer of a mochetochnik carry out a nefroureterektomiya in combination with removal of a bladder. In some cases (at the heavy combined pathology, bilateral damage of the only kidney and a chronic renal failure) apply less radical endoscopic techniques. In the postoperative period the patient with cancer of a mochetochnik appoint radiotheraphy, chemotherapy or vnutrimochetochnikovy immunochemotherapy. At inoperable new growths carry out conservative palliative therapy.
The forecast at cancer of a mochetochnik is defined by a tumor stage, level of a differentiation of cages, a condition of the second kidney, age of the patient, the accompanying somatic diseases and other factors. At noninvasive perekhodnokletochny cancer of a mochetochnik of recovery it is possible to achieve from 80% of patients, at invasive – from only 15%. The chemotherapy does not allow to eliminate completely cancer process, but approximately in 40% of cases provides long stabilization of a disease, however the forecast at metastatic tumors and recurrent cancer of a mochetochnik remains adverse.