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In this lecture, Professor Zach Murphy discusses urinary tract malignancies, emphasizing two of the most significant cancers affecting the urinary system—renal cell carcinoma (RCC) and bladder cancer.
We begin with renal cell carcinoma, reviewing its epidemiology, major risk factors such as smoking, obesity, hypertension, and genetic syndromes like von Hippel–Lindau disease. The discussion covers its hallmark clinical triad of hematuria, flank pain, and an abdominal mass, and other manifestations such as paraneoplastic syndromes (polycythemia, hypercalcemia, hepatic dysfunction). We explain diagnostic evaluation using imaging—highlighting CT and MRI as key tools—and the role of histopathologic subtypes, including clear cell, papillary, and chromophobe RCC.
Next, we transition to bladder cancer, beginning with its strong association with smoking, aromatic amine exposure, and chronic inflammation (e.g., schistosomiasis in endemic areas). We discuss common presentations like painless gross hematuria, frequency, urgency, and dysuria. The lecture reviews the diagnostic approach using cystoscopy, urine cytology, imaging, and the differences between non-muscle-invasive and muscle-invasive disease. Histologic emphasis is placed on urothelial carcinoma and addressing squamous cell and adenocarcinoma variants.
Finally, we compare the management strategies for each malignancy, including surgical resection, systemic therapy, immunotherapy, and intravesical treatments for bladder cancer. Prognostic factors, recurrence risks, and surveillance protocols are also discussed to give a comprehensive clinical picture.
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Table of Contents:
0:00 Lab
0:44 Pathophysiology of Urinary Tract Malignancies
16:30 Risk Factors for Renal Cell Carcinoma
20:54 Risk Factors for Bladder Cancer
25:22 Classic Findings of Urinary Tract Malignancies
30:53 Complications of Renal Cell Carcinoma
46:15 Complications of Bladder Cancer
52:11 Diagnostic Approach to Urinary Tract Malignancies
1:03:48 Treatment of Urinary Tract Malignancies
1:14:41 Comment, Like, SUBSCRIBE!