Editing Upper Urinary Tract Urothelial Cancer (section)

=== History and Physical Exam ===

==== History ====

* <span style="color:#ff0000">'''Signs and Symptoms'''</span>
** '''Most common presenting sign is hematuria'''
** '''Flank pain is the second most common symptom'''.
*** Pain is typically dull and believed to be '''secondary to a gradual onset of obstruction and hydronephrotic distention'''. 
***In some patients, pain can be acute and can mimic renal colic, typically due to the passage of clots that acutely obstruct the collecting system.
** Some patients are asymptomatic at presentation and are diagnosed when an incidental lesion is found on imaging

* <span style="color:#ff0000">'''Personal and family history'''</span>
** <span style="color:#ff0000">'''To identify known hereditary risk factors for familial diseases associated with Lynch Syndrome'''</span>
***'''If positive, referral for genetic counseling should be offered.[https://pubmed.ncbi.nlm.nih.gov/37096584/]'''
****Patients with Lynch Syndrome undergo routine screening due to increased life-long risk for developing associated malignancies, often occurring before 50 years of age[https://pubmed.ncbi.nlm.nih.gov/37096584/]
***'''<span style="color:#ff0000">Lynch syndrome</span>'''
****Familial, autosomal-dominant multi-organ cancer syndrome
****'''Accounts ≈7-20% of UTUC cases in the U.S'''
*****Lynch syndrome may increase the possibility of contralateral upper tract involvement, which is an important potential clinical consideration when developing a treatment plan.
****'''See [[Lynch syndrome|Lynch Syndrome Chapter Notes]]'''