A 65 year old male smoker presents with gross total painless hematuria. The most likely diagnosis is:
Correct Answer: Carcinoma of urinary bladder
Description: Answer is A (Carcinoma of urinary bladder) : "Painless haematuria is by Jar the most common symptom and should be regarded as indicative of bladder carcinoma unless proven otherwise." - Bailey The patient in question is 65 years of age and a smoker, both fa. ctors being predisposition to bladder carcinomas and presenting with the most common symptom of painless haematuria thus almost deliniating the diagnosis. Some facts about Bladder Carcinoma : Most common type of bladder carcinoma : Transitional cell carcinoma Most common type in areas where bilharzia is endemic - Pure Squamous cell Most common type arising from urachal remnant - Primary adenocarcinoma. Predisposing factors that have been asked : Tumors of urothelium i.e. Pelvis, ureter and bladder are most commonly Transitional cell carcinomas. But tumors of urethra are most commonly - squamous cell carcinomas. Naphthylamine / Aniline dyes Phenacctin exposure Cigarettte smoking Cyclophosphamide exposure Bilharzia Tyre, Rubber, cable and Dye industries
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