MALIGNANT TUMORS OF THE URINARY SYSTEM

MALIGNANT TUMORS OF THE URINARY SYSTEM 13.5% of total malignant tumors Urinary system Malignancy 1201 1 4 118 Urinary bladder Urethra Kidney Ureter Time Trend (Pathology) 70 60 50 40 30 20 10 0 SCC TCC Adeno Undiff ACC Bladder 4.4% TCC 92% Sarcoma & Unclassified CPR 2003-2004 % CPR 1985-1989 % 70 60 50 40 30 20 10 0 Time Trend of Cancer Bladder illustrated by Two Cancer Pathology Registries CPR 2003-2004 Squamous cell carcinoma Undifferentiated carcinoma Transitional Sarcomas & unclassified CPR 1985-1989 Adenocarcinoma Pathologic Classification of Transitional cell carcinoma Papillary non-invasive TCC ~23% Tumor cells Pa LP Invasive TCC ~77% Correlation between Clinical & Pathologic Classification of Transitional cell carcinoma Clinical Superficial Pathologic Papillary non-invasive (Pa) Superficially invasive (P1) Invasive Deeply invasive (P2 – P4) Cystoscopic examination by an experienced urologist is not a very useful tool for the assessement of the depth of invasion of urinary bladder tumors. Time Trend of Cancer Bladder illustrated by Two Cancer Pathology Registries 70 60 50 40 30 20 10 0 CPR 2003-2004 Pa P1 P2 P3 CPR 1985-1989 P4 Histopathologic types of malignant renal tumors – 118 cases Type Renal cell carcinoma No. 67 % 56.78 Wilms' tumor Transitional cell carcinoma Squamous cell carcinoma 44 5 1 37.28 4.24 0.85 PNET Total 1 118 0.85 100.00 MALIGNANT TUMORS OF THE MALE GENITAL SYSTEM 0.40% of total malignancy 0.48% of total malignancy 95.74 2.13 2.13 Seminoma Yolk sac tumor Malignant teratoma Fibrosarcoma Mixed germ cell tumor Embryonal carcinoma Undifferentiated carcinoma Leiomyosarcoma Adenocarcinoma PIN Adenocarcinoma PIN NHL Undifferentiated small cell carcinoma Prostatic Tumors – 47 cases Testicular tumors – 39 cases MALIGNANT SKIN TUMORS 3.74% of total malignant tumors Pediatrics Female Male Adults Malignant skin tumors Sites of malignant skin tumors -389 cases Head 10.3% 56.8% 3.6% Lower extr. Abdom en Neck Upper extrem ities Unspecified Chest Pelvis Low er extrem ities Head Malignant skin tumors Histopathologic types of malignant skin tumors -389 cases Basal 45.5% squamous 37.0% NHL 5.9% Basal cell carcinom a Verrucous carcinom a Sebaceous carcinom a Derm atofibrosarcom a NHL Squam ous cell carcinom a Malignant m elanom a Undifferentiated carcinom a Kaposi's sarcom a SOFT TISSUE SARCOMAS 2.74 % of total malignant tumors 28.00% pediatric cases No. 3 in ranking of pediatric malignancies Female Male Soft tissue sarcomas Sites of soft tissue sarcoms -268 cases Low er extrem ities Abdom en Unspecified Chest Pelvis Upper extrem ities Head Neck 0 20 40 11.2% 14.5% 32.5% 60 80 100 Soft tissue sarcomas Histopathologic types of soft tissue sarcoms -268 cases Liposarcom a Undifferentiated sarcom a Rhabdom yosarcom a Prim itive neuroectoderm al tum or Malignant fibrous histiocytom a Synovial sarcom a Malignant peripheral nerve sheath tum or Gastrointestinal tum or Fibrosarcom a Rare sarcom as Leiom yosarcom as Alveolar soft part sarcom a Vasular sarcom as 16.0% 14.9% 13.8% 0 10 20 30 40 50 MALIGNANT BONE TUMORS 1.92 % of total malignant tumors 54.80% pediatric cases No. 2 in ranking of pediatric malignancies Female Male Malignant Bone Tumors Sites of malignant bone tumors -222 cases Unspecified Thorax Vertebral column Skull Pelvis Upper extremities Lower extremities 0 20 40 60 80 9.9% 10.4% 50.4% 100 120 Malignant Bone Tumors Histopathologic types of malignant bone tumors – 222 cases Osteosarcoma NHL 9.0% Myeloma 6.3% Ewing's sarcoma Chondrosarcoma 14.9% 17.6% 47.7% Non-Hodgkin's lymphoma Plasma cell myeloma Other sarcomas Chordoma Langerhan's cell histiocytosis MALIGNANT ENDOCRINE SYSTEM TUMORS Formed 2.23% of total malignancies No. % Endocrine system tumors Lymphoid tumors Total 219 3 222 98.65 1.35 100.00 Sites of Malignant endocrine tumors- 222 cases 65.3% 15.3% 19.4% Thyroid Adrenal Extra-adrenal sites Malignant thyroid gland tumors M/F ratio 1:1.6 Adult cases 97.95% Histopathologic types of malignant thyroid tumors -145 cases 67.59 16.55 2.07 6.21 6.9 Papillary carcinoma Medullary carcinoma Non-Hodgkin's lymphoma Follicular carcinoma Anaplastic carcinoma Malignant Adrenal gland tumors M/F ratio 2.8:1 Pediatric cases 84.44% Histopathologic types of malignant adrenal tumors – 77 cases 46.7% 44.1% Adrenal gland neuroblastom a Extra-adrenal neuroblastom a Adrenal cortical carcinom a Others MULTIPLE MALIGNANT TUMORS Sites of multiple malignant tumors -183 cases 12.57 9.84 Breast 38.25 4.92 8.2 7.1 19.12 Breast Bladder Colorectal Skin Thyroid Ovary Other MULTIPLE MALIGNANT TUMORS MULTIPLE MALIGNANT TUMORS – 183 cases 31.15 Duct 17.49 14.21 2.73 5.46 8.74 20.22 Duct carcinoma Adenocarcinoma Basal cell carcinoma Rest Transitional carcinoma Squamous carcinoma Lobular carcinoma MULTIPLE MALIGNANT TUMORS Multiple malignant tumors in different anatomic sites- 6 cases No. Diagnosis and site of presentation 2 1 Laryngeal squamous carcinoma & papillary thyroid carcinoma Cervical squamous carcinoma & endometrial adenocarcinoma 1 1 1 Cervical squamous carcinoma & anal canal melanoma Cervical squamous carcinoma & bladder transitional cell carcinoma Endometrial adenocarcinoma & malignant rectal polyp 218 cases of borderline malignancy / Low malignant potential Others Desmoplastic fibroma Papillary transitional neoplasm Inflammatory myofibroblastic tumor Carcinoid tumor Hemangioendothelioma Myxoma Phyllodes tumor Verrucous neoplasm Ameloblastoma Epithelial ovarian tumors Giant cell tumor of Bones Fibromatosis Fibromatosis 8.25 1.38 1.38 1.83 1.83 2.75 3.67 3.67 4.13 5.05 7.34 18.35 40.37 0 5 10 15 20 25 30 35 40 45 46% Lymph nodes Peritoneum Soft tissues Lung Bone Bone marrow Liver Ovary Pleura Other 37% Adenocarcinoma Undifferentiated carcinoma Other Squamous carcinoma Duct carcinoma Signet ring carcinoma Transitional carcinoma Neuroblastoma 0 5 10 15 20 25 30 32% 35 40 Sites & Histopathologic types of tumors metastatic at initial presentation – 557 cases 28% 14% 33% Lymph nodes Soft tissue Lung Skin Bone Liver Rest Others Germ cell tumors Melanoma Transitional cell carcinoma Neuroblastoma Duct carcinoma Undifferentiated carcinoma Squamous cell carcinoma Sarcomas unspecified Adenocarcinoma 7.63 1.6 2.81 2.81 6.02 6.43 7.63 16.47 16.87 31.73 0 5 10 15 20 25 30 35 Sites & Histopathologic types of metastatic recurrent tumors – 249 cases Sites of locally recurrent malignant tumors – 522 cases Sof t tissue Skin Urinary bladder Oral cavity Other Colon & Rectum Breast Paranasal sinuses Vagina Bone Cervix Larynx Stomach Naso & Oropharynx Thyroid gland Urethra 34% 18% 6% 8% 0 5 10 15 20 25 30 35 40 Members of the Department of Pathology Surgical Pathology Unit, NCI Professor Dr. Hassan Nabil Tawfik Professor Dr. Nabil El-Bolkainy Professor Dr. Saad Eissa Professor Dr. Nadia Mokhtar Professor Dr. Nader Dahaba Professor Dr. Nayera Anwar Professor Dr. Magda Murad Professor Dr. Sumaya El-Huseiny Professor Dr. Hala Taha Professor Dr. Mustafa El-Kabany Professor Dr. Amani El-Deeb Dr. Akram Nouh Dr. Hoda Ismail Dr. Amani Abdel Hamid Dr. Mona Sakr Dr. Wael Tharwat Dr. Iman Gouda Dr. Iman Adel Dr. Tarek El-Bolkainy Dr. Asmaa Salama Dr. Iman Loay Dr. Dina Salah Dr. Nevine Fayez Dr. Safinaz Talaat Dr. Mohab Eissa No matter how good you may seem, You’re always better in a team Special Thanks to Dept. of Biostatistics: Prof. Inas El-Attar Dept. of Clinical Pathology : Prof. Azza Kamel Prof. Mohamed Husein Dr. Atef Badran