媽咪發現膀胱癌有腫瘤,但今日醫生話係轉移癌

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1128 Like 23 Dislike
2022-10-22 02:57:16
大把有錢人生cancer都係死架啦
2022-10-22 02:59:31
要處理好自己情緒,如果自己顧唔好點顧其他人,有唔開心真係要搵人傾,舒發下
2022-10-22 03:04:08
而家佢要接受現實+保持希望
膀胱瘤切除係微創,好快復原,行得走得。
touch wood 將來或要開大刀,佢都易啲接受同正面面對
2022-10-22 03:36:43
唔好意思,雖然你係醫生,但有唔少位我係想修正。

首先,樓主個醫生睇完病理報告彈去婦科而唔係繼續泌尿科,斷估係婦科腫瘤相關,唔似腎走落去嘅Renal Cell Carcinoma。推理如下﹕

1. 如果係由腎轉移過去的話個病理報告會著RCC+, CA9+, PAX8+, etc.; 如果係由子宮轉移,Cervix的話會著p16, PAX8+, Uterus會著ER+, PAX8+; 佢咁肯定彈過婦科好可能係睇完病理報告後發現冇著RCC+, CA9+; 同埋個病理報告實會寫清楚個histology個type, 譬如Squamous & Adenocarcinoma etc., RCC主要嘅type係Clear Cell or Non-clear Cell; 同婦科腫瘤係有分別,相信病理報告會寫好清楚,而主診醫生應該都唔會唔識分或搞錯;
2. 跟據UpToDate所講,"Secondary tumors account for approximately 15 percent of malignant bladder tumors. Cancers extending from the colon or rectum, prostate, and uterine cervix are most common and are most frequently identified in the bladder neck and trigone. Metastatic lesions from melanomas and stomach, breast, and lung cancers are less frequent." 當中只提到大概率係子宮頸癌有較大概率轉移過膀胱,但冇提及腎轉移膀胱。所以傾向相信係子宮轉移而非腎。

其次,子宮癌的話唔止adenocarcinoma;而膀胱原生癌亦唔只Transitional Cell Carcinoma.

子宮分子宮頸癌同子宮內膜癌

子宮頸癌 70-80%係Squamous, 20-25%係Adenocarcinoma , 仲有Adenosquamous, glassy cell, carcinoid, neuroendocrine, small cell...

子宮內膜癌 Endometrioid 80%, Papillary Serous 5-7%, Clear cell 3%, 仲有viloglandular, secretory....

而膀胱原生癌亦唔只Transitional Cell Carcinoma, 事實上有兩個分支,Urothelial Cancer (Transitional Cell Carcinoma) & Non-Urothelial Cancer (Squamous cell, Adenocarcinoma, Small Cell, Sarcoma...), 見圖


再根據上述嘅推理,Urothelial似乎係可以排除(因為樓主醫生彈去婦科),樓主媽嘅相對可能嘅係Bladder Cancer入面嘅Non-Urothelial Cancer. 咁究竟會係子宮頸癌定係子宮內膜癌?我睇子宮頸癌嘅概率相對高,因為只有子宮頸癌係有同Non-Urothelial Cancer嘅相對應轉移(Squamous & Adenocarcinoma),但子宮內膜癌係冇相對應嘅轉移。
2022-10-22 03:46:18
成個子宮切左佢得唔得
2022-10-22 03:50:50

媽咪麵有膀胱癌


2022-10-22 04:04:17
醫唔醫呢啲後話嚟
都要知第幾期同醫好嘅機會有幾高
2022-10-22 04:15:59
拎轉介信即排公立先

2022-10-22 04:32:49
2022-10-22 04:37:19
Take care ching
2022-10-22 04:44:17
2022-10-22 04:55:30
Metastasis好大鑊㗎喇喎,佢係由primary site轉移過嚟嘅,即係你邊度開始有cancer你都唔知!
如果嗰個報告話有嘅話,咁應該會準過個醫生就咁睇?
加油努力!!!
2022-10-22 05:01:26
呢個po咩事
又話連登仔好冷血冇人性好多hater乜都屌
還我冷血連登
2022-10-22 05:07:19
2022-10-22 06:31:22
其實2條路啦,叫你出去照再加照鏡,如果細細粒d醫生有時會咬左個粒細粒做化驗,但如果係大粒嘅話就一定book OT,樓主後尾加話屙唔到尿,相信幾大粒,直接book OT搞
2022-10-22 07:45:54
無公院醫都ok
2022-10-22 07:46:10
多謝
2022-10-22 08:15:24
樓主撐住
2022-10-22 08:18:49
靈芝先易出事
2022-10-22 08:20:06
樓上師兄話RCC機會大,佢有佢道理。我估好大原因係未爬文,樓主講到比較亂,一開始無講,要爬文先知愈多。如果爬文就發現樓主媽媽個醫生懷疑喺子宮,就唔會咁講。
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