<prompt> Transitional cell carcinoma is seen inPrepuceTestisProstateUrinary bladder  <response>: Ans. d Urinary bladderRef: Bailey Love 26th ed. 1330-35 Transitional cell epithelium lines - the urinary tract from the renal pelvis to the ureter, urinary bladder, and the proximal two-thirds of the urethra. Transitional cell carcinoma-Cancers can occur at any point mentioned above: 90 of malignancies develop in the bladder 8 in the renal pelvis 2 in the ureter or urethra.Salient features about urothelial tumors Bladder cancer is the fourth 4th most common cancer in men and the thirteenth 1 34 in women. Among urothelial tumors-95 are transitional cell in origin. Others are- Pure squamous cancers with keratinisation constitute 3, adenocarcinomas 2, and small cell tumors often with paraneoplastic syndromes 1. Adenocarcinomas Polychronotropism -urothelial tumors exhibit polychronotropism, which is the tendency to recur over time in new locations in the urothelial tract. Most imp risk factor- Cigarette smoking Other- aniline dyes, drugs phenacetin and chlornaphazine, external beam radiation. Chronic cyclophosphamide ,Schistosoma haematobiuma parasite-cause both see and tcc Vitamin A - protective. 3 clinical subtypes- Superficial 75 Invade muscle 20 Metastatic 5 Clinical presentation Hematuria painless- Most common presentation 80-90 of cases Irritative bladder symptoms such as dysuria, urgency, or frequency of urination occur in 20-30 of patients with bladder cancer. The bladder is the most common source of gross hematuria 40, Among bladder causes benign cystitis 22 bladder cancer 15 as a cause of hematuria Microscopic hematuria- is more commonly of prostate origin 25 MC site of lymphatic metastasis: -pelvic lymph nodes obturator MC MC site of hematogenous spread- LIVER LUNG Diagnosis- diagnosis and initial staging is made by cystoscopy and TUR. Newer; voided urine assays i.e., bladder tumor antigen , NMP-22, fibrinfibrinogen degradation products are being used for the detection and surveillance of urothelial carcinoma. Management-cystoscopy and TUR or biopsy Further management depends on stage, grade, size, multiplicity, recurrecnce pattern Drugs for intravesical chemo- Mitomycin,Thiotepa, Epirubicin,BCG most effective 