PSA-positive urethral adenocarcinoma of female genital tract

Maghsoudi, Amir; Lochhead, Alistair; Dally, Elizabeth; Starra, Eric; Lynnhtun, Kyaw

doi:10.1016/j.pathol.2019.01.011

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…One origin of primary urethral adenocarcinoma in females is thought to be the periurethral Skene’s glands, which are regarded as being functionally homologous to the prostate [ 6 , 19 ]. Although a positive PSA test result is considered as evidence of the origin from Skene’s glands [ 20 ], other studies have reported several PSA-negative adenocarcinomas that favored an origin from Skene’s glands, where cytochemical and immunohistochemical studies have found similarity to normal Skene’s glands [ 21 , 22 ]. Other studies have reported that chronic irritation of the urethral mucosa can cause intestinal metaplasia, or glandular urethritis, and thus alternative theories of origin have been proposed [ 5 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Primary Female Urethral Adenocarcinoma: Two Rare Case Reports and Literature Review

Tian

Tao

et al. 2023

Medicina

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Primary urethral adenocarcinoma in females is an extremely rare malignancy with unclear origin and only a few retrospective cases have been reported. The controversy continues to exist over the origin of primary urethral adenocarcinoma from periurethral glands (which include the Skene’s glands), urethritis glandularis or intestinal metaplasia. Herein, we report one case of a 49-year-old female with distal urethral adenocarcinoma who presented with obstructive voiding. Abdominal and pelvic CT scans and chest radiology were unremarkable. Biopsy of the mass confirmed urethral adenocarcinoma. The patient underwent partial ureterectomy and was disease-free at the 2-years follow-up period. We also present another extremely rare case of primary urethral adenocarcinoma with mucinous features in a 58-year-old female who initially complained of external urethral orifice itching with painless urethral bleeding and was treated with local excision. The patient has not received any neoadjuvant or adjuvant therapy, and experienced tumor recurrence, inguinal lymph nodes metastasis, and even local iliopsoas metastasis during over 10-years follow-up. In conclusion, our current study emphasizes the importance of imaging studies and biopsy in making an accurate preoperative diagnosis of this rare disease, and further highlights the role of multimodal therapy. A combination of radiotherapy, chemotherapy and surgery is recommended for the optimal local and distant disease control. Moreover, better medical compliance and regular follow-up are required in these patients.

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Section: Discussionmentioning

confidence: 99%

Management of Primary Female Urethral Adenocarcinoma: Two Rare Case Reports and Literature Review

Tian

Tao

et al. 2023

Medicina

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“…The morphological features of this entity are highly characteristic and have shown great similarity to male prostatic adenocarcinoma. 2,[8][9][10][11][12][13] These tumors express PSA, 2,8-13 PAP, 9,13 racemase, 11,12 and androgen receptors. 10 They are typically negative for CK20 and CK7.…”

Section: Discussionmentioning

confidence: 99%

“…10 They are typically negative for CK20 and CK7. [8][9][10][11][12][13] It is accepted that this subtype originates from periurethral glands of Skene. 4 The columnar/mucinous variant is generally formed by irregular tubular glands or papillary formations.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Subtypes and PD-L1 Expression in Primary Urethral Adenocarcinoma: A Series of 5 Cases

2021

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Background and Objectives Urethral adenocarcinoma is a rare disease with poor prognosis that can display multiple histologic patterns and has an unclear histogenesis. Radical surgery with extensive periurethral resection is the preferred therapeutic approach. Both chemotherapy and radiotherapy have been used as complementary treatment options. Due to the tendency of these tumors to recur, treatment-associated complications, and the limited choice of therapeutic options, patient management can be difficult. Given the lack of literature regarding immunotherapy in urethral adenocarcinoma, our objective was to explore the expression of programmed death receptor-ligand 1 (PD-L1) throughout the different histological subtypes of primary urethral adenocarcinoma. Methods We reviewed all primary urethral adenocarcinomas diagnosed at our hospital between 1965 and 2019, performed immunohistochemical assays on the tissue blocks, classified them according to their histology and origin, and performed PD-L1 (22C3) immunohistochemistry assays in all cases. Results We found a total of 5 cases of primary urethral adenocarcinoma. All of the patients were women. One of the cases was a cribriform adenocarcinoma, 2 were columnar-mucinous adenocarcinomas, and 2 were clear cell adenocarcinomas. One of the clear cell adenocarcinomas strongly expressed PD-L1. In addition, a profuse inflammatory infiltration constituted by CD3-positive and CD8-positive T lymphocytes within tumor cells was observed in this case. None of the other cases showed PD-L1 expression. Conclusions In conclusion, some urethral adenocarcinomas may strongly express PD-L1 and thus could potentially allow the use of immunotherapy in selected cases of advanced or recurrent adenocarcinoma.

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PSA-positive urethral adenocarcinoma of female genital tract

Cited by 2 publications

References 6 publications

Management of Primary Female Urethral Adenocarcinoma: Two Rare Case Reports and Literature Review

Management of Primary Female Urethral Adenocarcinoma: Two Rare Case Reports and Literature Review

Histopathological Subtypes and PD-L1 Expression in Primary Urethral Adenocarcinoma: A Series of 5 Cases

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