Suggestive for a Transitional Cell Carcinoma R Renal Pelvis

Lynn_65

https://csn.cancer.org/discussion/comment/1701266#Comment_1701266

My oncologist came on board after my partial nephrectomy. I see him every 6 months for CT scan and bloodwork. I would assume you would have one after the surgery for follow ups.

fallonboy

Thank you Lynn

My urologist has indicated he will be doing postop imaging and blood labs periodically.

Do you think an oncologist would be the best one to decide what treatment, if any , necessary postop?

In other words, if I need chemo would a oncologist know best, which drug and how much?

Biner

I never had oncologist, my urologist surgeon follow me.I think oncologist need if metastatic present

fallonboy

https://csn.cancer.org/discussion/comment/1701278#Comment_1701278

Thank you. I think we’ll know more once the pathology report comes back.

tgpath1

https://csn.cancer.org/discussion/comment/1701266#Comment_1701266

When they first diagnosed me (before my surgery), I met with an oncologist to discuss the possibilities. But since my cancer was contained in my kidney, I no longer need to see the oncologist. My understanding (and it's just from my experience so it could vary by doctor) is that you only need an oncologist if you need treatment beyond surgery. If I have a recurrence, I will have to see the oncologist again but as long as my scans are clear, I just see the urologist and nephrologist.

fallonboy

Right Kidney and tube to the bladder removed last week. I not talked to the doctors yet for the followup.

I got a copy of the pathology report. It says 2.5 carcinoma, no invasion identified, surgical margins neg. Also previous recent mri and ct scan and xr show no spreading

So far I think my stage is :  

• stage 0: Tis, N0, M0

Lets see if my 3 doctors agree.

Opinions please thanks

Take care

tgpath1

https://csn.cancer.org/discussion/comment/1701510#Comment_1701510

That is great news! It sounds like it was contained to the kidney. Here's hoping the doctors say the same!

Lynn_65

Not a doctor but that sounds like a great pathology report! Hope you hear from the doctors soon and they think so too. 🙏🏼

Biner

Cancer in situ best prognosis!

fallonboy

The nephroureterectomy was five days ago. No blood showing in the Foley bag until today. I go for my cystogram in two days. I hope they do not find any bladder leak .

Deanie0916

Fallonboy the pathology looks good. Hope you have uneventful scans in the future!

fallonboy

More of the pathology report. My next doctors appointment is after Thanksgiving.

Do you think I will need chemotherapy?

RIGHT KIDNEY AND URETER, RIGHT NEPHROURETERECTOMY:

PAPILLARY UROTHELIAL CARCINOMA, HIGH GRADE, INVOLVING THE RENAL PELVIS WITH EXTENSION INTO THE URETER MEASURING 2.5 CM.

NO INVASION IS IDENTIFIED. 

ALL SURGICAL MARGINS ARE NEGATIVE.

Synoptic Report

Your Value

RENAL PELVIS AND URETER: Resection

RENAL PELVIS AND URETER - All Specimens

8th Edition - Protocol posted: 6/30/2021

SPECIMEN

Procedure: Nephroureterectomy 

Specimen Laterality: Right 

TUMOR

Tumor Site: Renal pelvis 

Tumor Size: Greatest Dimension (Centimeters): 2.5 cm

Additional Dimension (Centimeters): 2.2 cm

Additional Dimension (Centimeters): 1.4 cm

Histologic Type: Papillary urothelial carcinoma, noninvasive 

Histologic Grade: High-grade 

Tumor Extent: Noninvasive papillary carcinoma 

MARGINS

Margin Status for Invasive Carcinoma: Not applicable 

Margin Status for Carcinoma in Situ / Noninvasive Papillary Urothelial Carcinoma: All margins negative for carcinoma in situ / noninvasive papillary urothelial carcinoma 

Closest Margin(s) to Carcinoma in Situ / Noninvasive Papillary Urothelial Carcinoma: Distal ureteral: 22 cm 

REGIONAL LYMPH NODES

Regional Lymph Node Status: Not applicable (no regional lymph nodes submitted or found) 

PATHOLOGIC STAGE CLASSIFICATION (pTNM, AJCC 8th Edition)

Reporting of pT, pN, and (when applicable) pM categories is based on information available to the pathologist at the time the report is issued. As per the AJCC (Chapter 1, 8th Ed.) it is the managing physician’s responsibility to establish the final pathologic stage based upon all pertinent information, including but potentially not limited to this pathology report.

pT Category: pTis 

pN Category: pN 

ADDITIONAL FINDINGS

Pathologic Findings in Ipsilateral Nonneoplastic Renal Tissue: Inflammation: 

Gross Description

Your Value

A. Kidney, Right.

The electronic surgical requisition and specimen container match patient’s name, date of birth, and specimen description.  Received in formalin labeled "right kidney and ureter" is a 657 g, 18 x 12 x 6 cm nephrectomy specimen with an 11 x 7 x 5 cm kidney, 22 x 0.4 cm ureter (inked black), abundant perinephric fat and no adrenal gland.  The mucosa of the renal pelvis at the opening to the ureter has a 2.5 x 2.2 x 1.4 cm red, soft, friable polypoid mass.  This is located 22 cm from the distal ureter margin, and 1.5 cm from the renal vein margin.  This mass dilates the opening to the ureter and renal pelvis.  A central 3 cm length of ureter is indurated with additional pink friable polypoid tumor filling the lumen and presumably extending from the ureter wall (blocks 4 and 5).  This area of central ureter tumor is 7 cm from the ureter margin and 10 cm from the renal pelvis.  The distal ureter has a red and indurated cut surface.  the remaining renal pelvis is lined by pink smooth mucosa.  The mucosa in the distal calices is focally abnormal reddened, hemorrhagic and irregular with possible scant tumor involvement.  There are multiple smooth walled cortical cysts up to 3 cm.  The largest peripheral cyst is partially septated; however, no excrescences are noted.  The renal parenchyma is red-brown with 0.7 cm cortex and 1.2 cm medulla.  The parenchyma is focally discolored tan and is slight indurated surrounding the distal calices.  No other overt masses are identified.  

Representative sections to include the entire mid to distal ureter cross sectioned are submitted in 20 cassettes labeled CES22-10360 A1-A20 as follows - 

A1, margins shaved (vein, artery, and ureter (inked blue))

2-5, ureter cross section sequentially from distal to proximal (4 and 5 contains possible tumor)

6-9, renal pelvis mass entirely submitted (6 includes perpendicular section from pelvis into proximal ureter)

10-18, renal parenchyma with distal calices and possible scant tumor involvement

19, distal calices with respect to largest septated cortical cyst

20, normal uninvolved kidney from upper pole.  

Microscopic Description

Your Value

A microscopic examination has been performed and the findings are incorporated in the diagnosis.

fallonboy

So does this mean I am NED?

AliceB1950

As far as I can tell, they got it all and you're stage 1. Grade without a number (unless I missed it) is odd, but some subtypes are graded differently. Mine was grade 4, highest possible, and I just get scans. After next year, when I'm five years out from surgery, I won't even get those unless I have symptoms. So you should have the basic follow-up routine of regular blood work and scans for now. Yay!

fallonboy

Hi, I am happy for you.

According to cancer. gov my transitional cell carcinoma of the renal pelvis is staged differently than RCC.

My urolo says he will do bladder scope every three months for two years. Then scans. He has not mentioned any “just in case” chemo or the need for an oncologist.

My urologist says my TCC has a chance of showing up in the bladder.

I see the urologist next week to get the 22 staples removed.

Good luck on you. Take care.