Radical Chemoradiotherapy for Urethral Squamous Cell Carcinoma: Two Case Reports and a Review of the Literature

Coop, Harold V.; Pettit, Laura; Boon, Cheng; Ramachandra, Prakash

doi:10.1155/2013/194690

Cited by 4 publications

(7 citation statements)

References 19 publications

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“…2 Depending on performance status, patients with locally advanced SCC might benefit from preoperative chemoradiotherapy (LE 4, GR C). 2 , 7 , 8 Depending on tumor stage and the patient’s performance status, radiotherapy or radical surgery, in combination with chemotherapy, are recommended treatment strategies. For superficial non-invasive penile cancer (Tis), topical chemotherapy, circumcision, laser therapy, or glans resurfacing have all been shown to be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Primary urethral squamous cell carcinoma: a unique manifestation of a penile tumor

et al. 2018

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This case report describes a unique manifestation of a primary urethral squamous cell carcinoma (SCC) as the underlying pathology in an 80-year-old male patient who underwent partial penectomy due to an enlarging penile mass. Persistent pain in the right knee was discovered to be a pathologic fracture using magnetic resonance imaging. Computed tomography-guided biopsy confirmed metastatic SCC. Whole-body positron emission tomography revealed systemic dissemination to multiple sites. Orthopedic knee replacement was performed in combination with local radiotherapy. Palliative chemotherapy was rejected due to poor performance status. Primary urethral SCC is rare and an uncommon cause of advanced penile cancer. These findings could be of great interest to clinicians for two reasons. First, a tumor’s appearance can be misleading. Consequently, histological work-up in accordance with clinical guidelines is necessary for accurate diagnosis. Second, a more comprehensive investigation is required when clinical symptoms persist despite the use of conventional treatment. Our case is an instance in which persistent pain masked the presence of downstream metastasis. We believe that these aforementioned points are of significant clinical importance and present a salient learning opportunity.

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Section: Discussionmentioning

confidence: 99%

Primary urethral squamous cell carcinoma: a unique manifestation of a penile tumor

et al. 2018

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“…1,3,5,9 In advanced disease, the overall response rate to cisplatinum-based chemotherapy alone and chemoradiotherapy are 72% and 83%, respectively. 3,4,6 Multimodal treatment with chemoradiotherapy and salvage surgery is recommended in advanced UC to improve local control and survival. [3][4][5] Salvage surgery alone improves 5-year disease-free survival rates from 54% to 72%.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,6 Multimodal treatment with chemoradiotherapy and salvage surgery is recommended in advanced UC to improve local control and survival. [3][4][5] Salvage surgery alone improves 5-year disease-free survival rates from 54% to 72%. 3,10 Multimodal treatment was planned for our patient.…”

Section: Discussionmentioning

confidence: 99%

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Primary squamous cell carcinoma of the urethral diverticulum mimicking prostate cancer: Case report and review of the literature

Ekin¹,

Yıldırım²,

Bayol³

et al. 2015

CUAJ

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Primary urethral carcinomas are uncommon, with urothelial carcinoma as the most common subtype. Urethral diverticulum is also rarely seen in men. A 44-year-old male presented with voiding symptoms. Abdominoperineal resection, prostatectomy, bladder neck excision, and proximal urethral excision were performed. A pathological examination revealed a well-differentiated squamous cell carcinoma (SCC) located inside an urethral diverticulum. We report this unusual case because primary SCC of the male urethral diverticulum is extremely rare. To our knowledge, our patient is only the second reported case. IntroductionPrimary urethral carcinoma (UC) is rare and accounts for less than 1% of all cancers.1,2 UC is the most common subtype. Generally, UCs are seen in the 5th decade.1,2 Patients presented with non-specific and overlapping clinical signs and symptoms.1,3 Management of UC is still controversial and challenging due to lack of experience.3 The surgical approach depends on the location and extent of the tumour. In advanced urethral squamous cell carcinoma (SCC), a combination of surgery, radiotherapy, and chemotherapy is recommended.3-6 The 5-year overall survival in patients with UC is about 50% to 55%. 2,3,5 Case reportA 44-year-old male presented with voiding difficulty and constipation for 3 months. He had a history of right nephrectomy for non-functional kidney secondary to a kidney stone. Although digital rectal examination revealed a hard, fixed mass on the anterior rectal wall, his prostate-specific antigen level was 0.61 ng/mL. A transrectal prostate biopsy was performed, and the pathological examination revealed a welldifferentiated SCC. The patient was referred to our urology clinic with a preliminary diagnosis of primary SCC of the prostate. A magnetic resonance imaging (MRI) showed a 6 × 7.2 × 8.1-cm round mass with smooth margins and heterogeneous internal enhancement. The mass abutted the rectum and bladder, and extended to the apex of the prostate and the levator ani without sign of invasion (Fig. 1). The prostate and lymph nodes were normal. For the purpose of a differential diagnosis, a colonoscopy was performed and the mucosa was normal. The patient underwent a cystourethroscopy and biopsy under anesthesia. We demonstrated a large wide-mouthed urethral diverticulum and tumour growth in the bulbomembranous urethral diverticulum. The prostate was normal and the dimensions of the prostate were compatible with the patient's age. The bladder mucosa was intact, with external tumour compression. A histopathologic examination revealed a well-differentiated SCC with an inverted and warty growth pattern, keratinization with keratin pearl and dyskeratotic cells.The patient was informed about the radical cystoprostatectomy and abdominoperineal resection if organ preservation was unfavourable, and informed consent was obtained. Abdominoperineal resection, prostatectomy, bladder neck excision, and proximal urethral excision were performed. On gross examination of the excision specimen, there was the pr...

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“…Although surgery alone is considered effective in early-stage disease, multimodal therapy (surgery, radiotherapy, and/or chemotherapy) is currently recommended for advanced diseases [6][7][8][9]. Following recent data, chemoradiotherapy without use of surgery for selected patients with advanced disease may offer good short-term outcomes [9][10][11][12][13][14][15][16][17]. We report the case of a 48-year-old woman suffering from advanced high-grade urothelial carcinoma of distal urethra with bilateral inguinal node metastasis who benefited from chemoradiotherapy only with complete metabolic response.…”

Section: Introductionmentioning

confidence: 99%

Advanced Female Primary Urethral Carcinoma with Nodal Extension Managed with Exclusive Use of Chemoradiotherapy: Report of a Case and Review of the Relevant Current Literature

Al Barajraji,

Holz,

Moussa

et al. 2023

Case Rep Oncol

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Primary urethral carcinoma (PUC) is a rare disease with frequent nodal metastasis at the time of diagnosis. Few risk factors have been established and overall prognosis remains poor. As of now, no clear therapeutic guidelines are established and management of advanced PUC often involves surgery which can have negative functional and psychological outcomes for the patient. Few authors have already reported the use of chemoradiotherapy alone to avoid surgery with some good short-term results. We report the case of a 48-year-old woman with advanced high-grade urothelial carcinoma of distal urethra associated to bilateral inguinal nodal metastasis. She was similarly and successfully treated using chemoradiotherapy exclusively without significant adverse effects. This experience reinforces benefits of a surgery-sparing management, when possible, as recommended in current guidelines.

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Radical Chemoradiotherapy for Urethral Squamous Cell Carcinoma: Two Case Reports and a Review of the Literature

Cited by 4 publications

References 19 publications

Primary urethral squamous cell carcinoma: a unique manifestation of a penile tumor

Primary urethral squamous cell carcinoma: a unique manifestation of a penile tumor

Primary squamous cell carcinoma of the urethral diverticulum mimicking prostate cancer: Case report and review of the literature

Advanced Female Primary Urethral Carcinoma with Nodal Extension Managed with Exclusive Use of Chemoradiotherapy: Report of a Case and Review of the Relevant Current Literature

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