MALIGNANT-TUMORS OF UPPER URINARY-TRACT - AN EXPERIENCE IN BENGHAZI

Objective: To study the distribution, clinical aspects, management, an d follow-up of upper urinary tract rumors in general and pelviureteric transitional cell carcinoma in particular among the total genitourina ry malignancies managed at our institution. Design: A retrospective an alytical study of histopathologically confirmed cases of upper urinary tract tumors managed over fourteen years (Jan.1983 - Dec.1996). Setti ng: 7th October - University (teaching) Hospital, Benghazi (end point referral unit for genitourinary cases for North-Eastern Libya). Subjec t: Records of all the twenty cases of upper urinary tract tumors were critically evaluated and data collected. Results: The upper urinary tr act tumors are uncommon comprising only 2.94% (20/680) of all genitour inary tumors. The incidence of transitional cell carcinoma of upper ur inary tract was noted to be 5.36% (17/317) among transitional cell car cinoma of whole urinary tract. These cases were mainly distributed in 6th-7th decades with a male predilection. Frank total hematuria was th e main clinical presentation (80%). In one patient metastasis to Virch ow's lymph node was an unusual finding. As two thirds of cases were ha ving muscle-invasive (high stage/high grade) disease, therefore, the e xtent of surgical resection alone could not affect the survival and pr opensity of recurrence to lower urinary tract. However, complete nephr oureterectomy with removal of bladder mucosal cuff is the only as yet available therapy for this disease.