Transitional cell carcinoma

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Transitional cell carcinoma is a type of cancer that arises from the transitional epithelium, a tissue lining the inner surface of these hollow organs.^[1] It typically occurs in the urothelium of the urinary system; in that case, it is also called urothelial carcinoma. It is the most common type of bladder cancer and cancer of the ureter, urethra, and urachus. Symptoms of urothelial carcinoma in the bladder include hematuria (blood in the urine). Diagnosis includes urine analysis and imaging of the urinary tract (cystoscopy).

It accounts for 95% of bladder cancer cases and bladder cancer is in the top 10 most common malignancy disease in the world and is associated with approximately 200,000 deaths per year in the United States alone.^[2][3] It is the second most common type of kidney cancer, but accounts for only five to 10 percent of all primary renal malignant tumors.^[4] Men and older people have a higher rate of urothelial carcinomas. Other risk factors include smoking and exposure to aromatic amines.^[5]

Treatment approaches depend on the stage and spread of the tumour. Tumour removal (resection), chemotherapy and chemoradiation may be indicated.

Signs and symptoms of transitional cell carcinomas depend on the location and extent of the cancer. Symptoms of bladder cancer is blood in the urine.[5]

Urothelial carcinoma is a prototypical example of a

1. Certain drugs, such as
   upper urinary tract).^[7]
2. Radiation exposure
3. RAS (oncogene) and epidermal growth factor receptor (EGFR).^{[citation needed}
   ]
4. Presence of an abnormal extra chromosome, classified as a small supernumerary marker chromosome (sSMC), in this malignancy's tumor cells.^{[citation needed]} The sSMC has an isochromosome-like structure consisting of two copies of the short (i.e. p) arm of chromosome 5. In consequence, the malignant cells bearing it have four copies of this p arm's genetic material, two from each of the normal chromosome 5's and two from the sSMC.^[8] "sSMC i(5)(p10)" is the single most common recurrent structural chromosomal abnormality in transitional cell carcinoma, being present in its malignant cells in most cases of the disease. Transitional cell bladder carcinomas associated with this sSMS are more aggressive and invasive than those not associated with it.^[9]

Transitional cell carcinomas are often multifocal, with 30–40% of patients having more than one

Transitional cell carcinomas are mostly papillary (70%,^[2] and 30% non-papillary).^[2]

The 1973

• 
  Transitional cell carcinoma, being low-grade to the left, and high-grade to the right. H&E stain
• 
  Papillary transitional cell carcinoma, low grade
• 
  Histopathology of urothelial carcinoma of the urinary bladder, showing a nested pattern of invasion. Transurethral biopsy. H&E stain
• 
  Histopathology of urothelial carcinoma of the urinary bladder.
• 
  Histopathology of urothelial carcinoma of the urinary bladder.
• 
  Micrograph of urethral urothelial cell carcinoma. H&E stain

Transitional cell carcinomas can be very difficult to treat. Treatment for localized stage transitional cell carcinomas is surgical resection of the tumor, but recurrence is common. Some patients are given

Localized/early transitional cell carcinomas can also be treated with infusions of

Taxanes or vinflunine have been used as second-line therapy (after progression on a platinum containing chemotherapy).^[16]

Immunotherapy such as pembrolizumab is often used as second-line therapy for metastatic urothelial carcinoma that has progressed despite treatment with GC or MVAC, however this is based on low certainty evidence.^[17][5]

In May 2016, the FDA granted

In April 2021, the FDA granted accelerated approval to sacituzumab govitecan for people with locally advanced or metastatic urothelial cancer (mUC) who previously received a platinum-containing chemotherapy and either a programmed death receptor-1 (PD-1) or a programmed death-ligand 1 (PD-L1) inhibitor.^[20]

Transitional cell carcinomas can also be associated with the prostate.^[21][22]

• Bladder cancer in cats and dogs
• Transitional cell carcinoma of the ovary