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Radiology, Vol 167, 613-618, Copyright © 1988 by Radiological Society of North America

ARTICLES

Synchronous and metachronous transitional cell carcinoma of the urinary tract: prevalence, incidence, and radiographic detection

DM Yousem, OM Gatewood, SM Goldman and FF Marshall
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.

Six hundred forty-five cases of transitional cell carcinoma (TCC) of the bladder, ureter, and/or kidney were reviewed retrospectively to determine the frequency of synchronous and metachronous lesions elsewhere in the urinary tract. Among 597 patients with TCC of the bladder, 23 (3.9%) developed an upper-tract lesion, after an average delay of 61 months. Metachronous upper-tract tumors developed in 13% of 38 patients with primary ureteral TCC and in 11% of 63 with renal TCC, after average delays of 28 and 22 months, respectively. Synchronous TCC was found in 2.3% of patients with bladder TCC, 39% of those with ureteral TCC, and 24% of those with renal TCC. Seventeen percent of the subsequent upper-tract lesions would have been demonstrated by intravenous or retrograde urography performed 1 year after the initial onset of primary bladder cancer, and 61% would have been demonstrated by studies performed within 2 years. Therefore, the authors recommend annual radiologic evaluation of the upper urinary tract for 2 years after initial diagnosis and treatment of an upper-tract or bladder TCC.


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