Primary urethral transitional cell carcinoma in a female

Abstract

A 60-year-old woman attended the gynaecology clinic with postmenopausal bleeding. She underwent hysteroscopy with dilatation and curettage, which were normal. She was referred to urology because there was an induration along the urethra and a small polypoid mass protruding through the external urinary meatus. Cystourethroscopy showed a papillary growth in the distal urethra; the bladder was normal. Biopsy of the urethral lesion showed moderately differentiated invasive TCC (Fig. 1), but random biopsies of the bladder were normal. CT of the abdomen and pelvis detected no lymphadenopathy and both kidneys were normal. She was managed by radical cysto-urethrectomy, pan-hysterectomy and excision of the anterior vaginal wall.

Primary Clear Cell Adenocarcinoma of a Urethral Diverticulum Treated with Multidisciplinary Robotic Anterior Pelvic Exenteration

“…In the urethra, the cause of diverticula is often unknown but encompasses acquired and congenital subtypes. It has been hypothesized that rupture of infected periurethral glands into the urethral lumen may be responsible for most acquired cases [6, 7]. This is supported by the prevalence of clear cell adenocarcinoma arising from diverticula and may be of particular interest here, as our case involved a female presenting initially with recurring urinary tract infections.…”

“…Indeed, 55% of urethral carcinoma recurs despite treatment and 10-year survival remains at only 60% [3]. Clinically, palpable lymph nodes are found in about third of patients and more than 90% are metastatic at diagnosis [7]. Clear cell adenocarcinoma remains a grave diagnosis but has the most favorable prognosis of the three most common urethral cancers with 54% experiencing disease free survival with any treatment modality and a disease free survival rate of 73% when treated with anterior exenteration alone [5].…”

Detection of human papillomavirus in a urothelial carcinoma mimicking urethral caruncle

“…Primary UC of the distal urethra is extremely rare in women, and only five such cases have been reported in the published English‐language literature (Table 1). 1–3 The patient affected in the present case is the youngest so far. All of the previously reported cases were invasive tumors, but the present case is the first to have been manifested macroscopically as a urethral caruncle‐like lesion.…”

“…There is a current view that HPV infection is associated with cervical carcinogenesis. In addition, HPV infection has been detected in UC of the urinary tract, such as those of the urethra, urinary bladder, renal pelvis and ureter 1–3,5,6 . In contrast, several studies have failed to detect HPV infection 5,6 .…”

“…Otherwise, tumors arising in more proximal regions tend to be urothelial carcinoma (UC), because of the predominance of transitional epithelium as the background tissue. Primary UC of the distal urethra is very rare in women, and only five such cases have been reported in the English‐language literature 1–3 …”