Adenocarcinoma of the urethra during pregnancy: report of a case

The first case of adenocarcinoma of the urethra occurring during pregnancy is discussed. The patient was in her second trimester, and the pregnancy was allowed to continue to term. The patient was delivered vaginally of a healthy infant. Following delivery, she was treated with radiotherapy. After completion of the radiotherapy, the distal half of the urethra was excised. The patient has been followed for 7 years, and there is no evidence of recurrence.

Experience with primary carcinoma of the male urethra

We reviewed 23 cases of primary carcinoma of the male urethra and compared the clinical findings, treatment and results to the experiences previously reported. Patients with lesions of the pendulous urethra managed by appropriate amputation of the penis with ilio-inguinal node dissection for groin metastases had a good prognosis, whereas patients with lesions of the bulbo-membranous or prostatic urethra had a poor prognosis. Despite occasional successful results with conservative surgical excision and over-all poor results with radical excision the generally extensive nature of such tumors necessarily makes radical excision the treatment of choice.

Prostatic caruncle: a urethral papillary tumor derived from prolapse of the prostatic duct

Tiny papillary tumors of the prostatic urethra in and around the verumontanum were demonstrated by urethroscopy in 21 patients who presented with hematuria. Histopathologic study revealed evagination of prostatic glands with polypoid, papillary and angiectatic patterns in varying degrees. We suggest that these lesions may be called prostatic caruncles because of their close similarity to female urethral caruncles. The mild inflammatory changes noted in our patients were considered secondary reactions to the local circulatory disturbance and erosion.

Benign periurethral masses in women

Benign periurethral masses were encountered in 4 women. The masses included 2 vaginal leiomyomas, 1 of which was found simultaneously with a urethral diverticulum, a fibrocystic urethral mass and hyperplastic glandular tissue obstructing the bladder outlet and resembling male prostate. The physical and endoscopic features were helpful in establishing the benign nature and extent of the lesions. Although the bladder base was deformed on an excretory urographic cystogram in each case the radiographic features were non-specific except as they applied to a urethral diverticulum. Transvaginal needle biopsy is recommended in contemplation of open surgical excision. Leiomyomas are best approached transvaginally and anterior urethral masses can be reached suprapubically.

Primary malignant melanoma of the female urethra

We herein report a case of primary malignant melanoma of the female urethra, summarize the histopathology, review the available literature and discuss the treatment. Although a definitive regimen for the treatment of this virulent malignancy has not been established a 10-year-survival has been obtained by surgical extirpation preceded by preoperative radiotherapy.

[Inverted urothelial papilloma (author's transl)]

Casuistic report dealing with the observation of an inverted papilloma arising from the pars prostatica urethrae. By means of the literature, clinical and pathologic problems of this scarcely known neoplasm, which was not delimitated in the German literature before 1963, are discussed.

Morphological and clinical observations of patients with early bladder cancer treated with total cystectomy

In 21 cases, early bladder cancer was detected by urine cytology, although not by cystoscopy, and was treated by total cystectomy. The neoplasms, all transitional cell carcinomas of moderate to high degrees of anaplasia, were entirely in situ in 17 of the 21 patients; in 4, although mainly in situ, the tumors showed additional minimal microinvasion. Widespread mucosal involvement was demonstrated in every case by step-sectioning, and extension into the prostatic ducts occurred in 7 of the 19 male patients and into the mucosa of one or both distal ureters in 12 patients. Premalignant atypia of the mucosa was also widespread and direct intramucosal spread of cancer cells was a significant factor, particularly along the prostatic ducts and ureters. The duration of significant symptoms (follow-up for 9 years before cystectomy in several cases and for 8 years in 1 histologically proved case) suggests that the evolution of these tumors may be considerably longer than previously documented.

Leiomyoma of the female urethra: a case report

A case of leiomyoma of the female urethra arising from the anterior lip of the external urinary meatus is presented. The tumor was missed originally and, subsequently, increased in size. Although the neoplasm was suspected clinically, it was confirmed only by histopathology. The tumor was responsible for recurrent urinary tract infection, which ceased after the neoplasm was excised.

Urethral carcinoma after radiation therapy for mixed prostatic carcinoma

The first case of transitional cell carcinoma of the bulbous urethra occurring 8 months after radiation therapy for mixed ductal and adenocarcinoma of the prostate is presented. The significance of the sequential appearance of these tumors is discussed. Periodic endoscopic evaluation appears warranted following the diagnosis of transitional cell carcinoma of the prostate to ensure early recognition of secondary urethral lesions or bladder extension of the tumor.

A spectrum of malignant epithelial tumors of the prostate gland

Conceptually, the prostatic territory encompasses neoplams whose origins are intraprostatic, paraprostatic or extraprostatic. Our objectives in this review are to 1) present a classification of the spectrum of malignant epithelial growth encountered in the prostatic territory, 2) show examples of these neoplasms and remark upon their histogenesis, enzyme production and endocrine sensitivity, and 3) suggest re-evaluation of some of our current routine therapeutic procedures.

Primary carcinoma of fossa navicularis

A case of primary carcinoma of the fossa navicularis of the male urethra is discussed. The lesion presented as an ulcerative process that circumferentially involved the external urinary meatus in a sixty-three-year-old man. Initially, the lesion was confused with a superficial carcinoma of the penis, since results of urethroscopic examination were normal. Following midshaft penectomy, despite normal gross appearance of the distal urethra, histologic examination indicated poorly differentiated epidermoid carcinoma along the mucosa of the distal urethra up to the line of surgical resection. Subsequent total penectomy showed only a small area of residual tumor at the line of previous resection. Lymphadenectomy was not performed. The patient remains alive without evidence of residual disease five years later.

Transitional cell carcinoma of the urethra in men having cystectomy for bladder cancer

Charcteristics of urethral transitional cell carcinoma in patients who have undergone cystectomy for bladder cancer have been reviewed. The retained urethra was the site of urothelial malignancy in 7 per cent of 348 patients who underwent cystectomy alone. Urethras removed during prophylactic cystourethrectomy in 110 patients showed unsuspected carcinoma in situ and marked atypic in 12.5 per cent. Patients with urethral cancer were at greater risk for meatal and upper tract tumors, a reflection of multicentric tumor neogenesis, and at greater risk for perineal tumors and inguinal metastases, a reflection of direct invasion. Cytology is advocated for examining the retained urethra. However, urethrectomy to include a fossa navicularis and glandular meatus at the time of cystectomy seems justified as a definitive means of guarding against the often asymptomatic and potentially lethal urethral occurrences of transitional cell carcinoma. Furthermore, incontinuity removal of the bladder and urethra more nearly satisfies the requirements for cancer surgery by avoiding transection of a tumor containing viscus.

Transitional cell carcinoma of the urethra in a cat

A case of transitional cell carcinoma of the prostatic and anterior pelvic urethra of a cat is presented. Primary urinarty tract neoplasms in the cat are rare, and transitional cell carcinoma with major involvement of the urethra has not been previously reported. The appearance and location of this tumor made differentiation from a prostatic carcinoma difficult. The clinical presentation consisted of emaciation, constipation, anorexia, and hematuria.

Primary adenocarcinoma of the female urethra

Three cases of primary adenocarcinoma of the female urethra are presented. The tumour in the first case was associated with urethritis glandularis and is thought to arise from previous glandular metaplasia of the urethral mucosa. The tumour in the second case resembled the clear-cell carcinomas of the lower female genital tract and is thought to be of embryonic rest origin. The tumour in the third case is thought to arise from the paraurethral glands.

Urethral hyperthermia: an alternative to urethrectomy

Nine male dogs were subjected to cystoprostatectomy, ileal loop diversion, and urethral hyperthermia. Five of the 9 dogs survived six weeks. Three of the 5 surviving dogs had complete destruction of the urethral epithelium, and the other 2 dogs had 95 per cent and 50 per cent destruction with the proximal urethral end incompletely destroyed. Complete urethral destruction may have been obtained with resection of the proximal urethra postirrigation. The irrigation added no extra time to the surgical procedure and was accompanied by few complications. Complications may have been averted with a dorsal slit and meatotomy.

Leiomyoma of vesicovaginal septum causing urinary retention

A case of leiomyoma of the vesicovaginal septum causing acute urinary retention and an unusual radiographic filling defect in the flood of the bladder is presented. This is a rare lesion which can be the source of confusion. It has similar microscopic appearance to lesions which the patient had previously in the esophagus and stomach, left labia, and the uterus. Microscopically, all of the tumors were benign.

Urinary obstruction secondary to prostatic involvement from postoperative extension of carcinoma of rectosigmoid

Two cases of urinary obstruction secondary to neoplastic involvement of the prostate from abdominal-perineal resection for carcinoma of the rectosigmoid are discussed. A review of the literature and the management of this infrequent entity is described.

Primary carcinoid tumor of the urethra

The first reported case of a carcinoid tumor of the urinary tract is presented. Because of rapid local recurrence and distant spread early radical surgery is recommended. Several methods of palliation of the carcinoid syndrome-surgical, pharmacologic and chemotherapeutic-are discussed.