Upper tract urothelial carcinoma

What it is

Upper tract urothelial carcinoma (UTUC) is transitional cell carcinoma above the bladder; the bladder itself is the most common site of TCC.

The risk of upper tract TCC in a case of bladder TCC is 3-5%. The risk of lower tract TCC is 75%.

How it presents

Painless hematuria in a patient older than 40 years, with risk factors, is likely TCC; smoking is the risk factor named. Hematuria on anticoagulation should still be investigated for underlying urothelial pathology.