Primary Clear Cell Adenocarcinoma in a Female Urethral Diverticulum: A Case Report and Review

Sheahan,

doi:10.4021/wjnu67w

Cited by 5 publications

(15 citation statements)

References 9 publications

(13 reference statements)

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“…Patients present with the same symptoms than the other urethral carcinomas, especially hematuria 1, 2, 3. CT scan or MRI show a heterogeneous mass of the urethra, which may be localized in a diverticulum 4, 5. Diagnosis is made by urethrocystoscopy with biopsies 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Microscopic examination reveals hobnail and flattened cells with abundant clear cytoplasm, moderate to marked nuclear pleomorphism with frequent mitotic figures 1, 2. Tumor cells may show positive immunohistochemical staining for PAX2, PAX8, cytokeratin 7, p16, p53, CA125, CAM5.2, AE1/AE3 1, 4. In most reported cases, the treatment was anterior pelvic exenteration and pelvic lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

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Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele

Ayari

Kerkeni

Znaidi³

et al. 2017

Urology Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele

Ayari

Kerkeni

Znaidi³

et al. 2017

Urology Case Reports

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“…MRI scan may reveal urethral diverticulum containing a nodular enhancing malignancy [ 6 ] or a heterogeneous mass in the urethra [ 5 ].…”

Section: Literature Reviewmentioning

confidence: 99%

“…CT scan may reveal urethral diverticulum containing a heterogeneous mass [ 5 , 6 ]. It could be imagined that if there is no urethral diverticulum the CT scan may demonstrate urethral mass only.…”

Section: Literature Reviewmentioning

confidence: 99%

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Clear Cell Adenocarcinoma of the Urethra: Review of the Literature

Venyo

2015

International Journal of Surgical Oncology

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Background. Clear cell adenocarcinoma of the urethra (CCAU) is extremely rare and a number of clinicians may be unfamiliar with its diagnosis and biological behaviour. Aims. To review the literature on CCAU. Methods. Various internet databases were used. Results/Literature Review. (i) CCAU occurs in adults and in women in the great majority of cases. (ii) It has a particular association with urethral diverticulum, which has been present in 56% of the patients; is indistinguishable from clear cell adenocarcinoma of the female genital tract but is not associated with endometriosis; and probably does not arise by malignant transformation of nephrogenic adenoma. (iii) It is usually, readily distinguished from nephrogenic adenoma because of greater cytological a-typicality and mitotic activity and does not stain for prostate-specific antigen or prostatic acid phosphatase. (iv) It has been treated by anterior exenteration in women and cystoprostatectomy in men and at times by radiotherapy; chemotherapy has rarely been given. (v) CCAU is aggressive with low 5-year survival rates. (vi) There is no consensus opinion of treatment options that would improve the prognosis. Conclusions. Few cases of CCAU have been reported. Urologists, gynaecologists, pathologists, and oncologists should report cases of CCAU they encounter and enter them into a multicentric trial to determine the best treatment options that would improve the prognosis.

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A Rare Case of Advanced Urethral Diverticular Adenocarcinoma and a Review of Treatment Modalities

Oluyadi

Ramachandran

Gotlieb

2019

Journal of Investigative Medicine High Impact Case Reports

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Female urethral diverticular cancer is a very rare entity with only around 100 cases reported so far in literature and accounts for <1% of all malignancies. In this article, we present a 47-year-old African American female with repeated hospital visits for urinary retention, hematuria, and urinary tract infections. Initial computed tomography imaging and cystoscopy was unremarkable except for a distended urinary bladder. Subsequent magnetic resonance imaging and corresponding cystoscopy eventually indicated the presence of a urethral diverticulum. She underwent urethral diverticulectomy and was found to have a mass arising from urethral diverticulum extending to vaginal walls. Her biopsy was suggestive of invasive adenocarcinoma in advanced stages, for which she subsequently underwent a total pelvic exenteration. Next-generation sequencing of the tumor showed CDKN2A/B loss, MSI-stable, and low TMB, thereby ruling out the options for targeted therapies. Extensive literature search and expert opinions were sought for her case since no consensus exists regarding the optimal therapeutic approach due to the rarity of this tumor. A final decision was made to treat her with platinum-based chemotherapy. Different treatment approaches including neoadjuvant chemoradiation followed by surgery, surgery followed by adjuvant chemotherapy, and surgery followed by chemoradiation have been tried. Platinum-based chemotherapy has generally been preferred based on an extensive literature search. Multimodality treatment approach seems to be the current approach to management for advanced stages for better overall survival. This case illustrates the challenges faced in making diagnosis and treatment decisions due to the rarity of this type of tumor and lack of consensus in the treatment approach.

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Primary Clear Cell Adenocarcinoma in a Female Urethral Diverticulum: A Case Report and Review

Abstract: Elmer This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Cited by 5 publications

References 9 publications

Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele

Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele

Clear Cell Adenocarcinoma of the Urethra: Review of the Literature

A Rare Case of Advanced Urethral Diverticular Adenocarcinoma and a Review of Treatment Modalities

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