Diagnostic and Therapeutic Challenges of Rare Urogenital Cancers: Urothelial Carcinoma of the Renal Pelvis, Ureters and Urethra

Abstract

Urothelial carcinoma (UC) is a neoplastic growth that affects the lining of the urinary tract from the renal pelvis to the distal urethra. Urothelial cancer occurs less commonly along the upper urinary tract (renal pelvis and ureter) accounting for 5-10% and even rarer along the urethra approximately less than 1%. The incidence of UC of the upper urinary tract and urethra has been reported in the United States and Europe by the Surveillance, Epidemiology, and End Results Program and the Rare Cancers in Europe project, respectively. Considering the rarity of upper tract urothelial carcinoma (UTUC) and primary urethral cancer (PUC), there is a paucity of data from Sub-Saharan Africa. Both the European Association of Urology guideline and the National Comprehensive Cancer Network guideline have provided some clinical updates on the management of UTUC and PUC. However, UTUC and PUC present mostly at a more advanced stage than UC of bladder. A high index of suspicion is necessary for diagnosis even more for UTUC. Organ-sparing surgery is possible for both localized UTUC and PUC but stringent follow-up with urine cytology, endoscopy and imaging is mandated for early detection of recurrence.

A Single-Center Study of Patients With Synchronous Primary Malignancy: A Case Series

“…Upper tract UC (UTUC) is three times more common in males than in females and it peaks at the age of 70-90 years. The development of UTUC is linked to both hereditary and environmental factors [ 27 ]. A strong association has been found between upper urinary tract urothelial cell carcinomas (UUT-UCC) and hereditary non-polyposis colorectal cancer (HNPCC), as HNPCC carriers have a 22-fold higher risk of developing UUT-UCC than the general population [ 28 ].…”

Initial Staging and Response Evaluation With 18F-FDG PET/CT in a Rare Case of Nested Variant Urothelial Urethral Cancer

“…Primary urothelial urethral cancer is a rare and serious type of cancer that occurs in the urethra, accounting for less than 1% of all urothelial cancers. [1][2][3][4] Nested variant urothelial carcinoma of the urethra is an even rarer and more aggressive form of this cancer. [4][5][6][7] Although there are no published studies on the role of 18 F-FDG PET/CT imaging in patients with primary urothelial urethral cancer, previous articles have reported on the uptake of FDG in the urethra due to metastases from other cancers, inflammation, and normal variation.…”

“…The urinary bag, urine contamination, and ileal conduit were visible in the MIP image (red arrow in F ). Primary urothelial urethral cancer is a rare and serious type of cancer that occurs in the urethra, accounting for less than 1% of all urothelial cancers 1–4 . Nested variant urothelial carcinoma of the urethra is an even rarer and more aggressive form of this cancer 4–7 .…”

Screening for urothelial carcinoma cells in urine based on digital holographic flow cytometry through machine learning and deep learning methods

“…1 The incidence of urothelial carcinoma in the elderly continues to rise annually. 2 Early non-invasive UC can be effectively treated with minimally invasive procedures such as transurethral bladder tumor resection and ureteroscopic removal of upper tract tumors. In contrast, surgical interventions for invasive UC carry significant trauma and a high complication rate.…”