An adenosquamous carcinoma of the male urethra with hypercalcemia

Clear cell adenocarcinoma of the prostatic utricle in an adolescent

We present a case of a 16-year-old boy with a primary clear cell adenocarcinoma of the prostatic utricle. The patient presented with a 6-month history of intermittent, nonpainful, gross hematuria and an associated right renal agenesis. Radiographic studies revealed the presence of a solid and cystic mass between the bladder neck and the cranium of the prostate. Serum tests, including prostate-specific antigen, carcinoembryonic antigen, CA-19-9, and human chorionic gonadotropin, were performed and found to be within normal limits. A surgical resection of the mass including prostate and seminal vesicles was performed. Grossly, a polypoid exophytic tumor was present at the prostatic utricle. Histologically, the tumor shows the classical clear cell morphology reminiscent of the so-called mesonephric adenocarcinomas. At clinical follow-up, the patient is alive and well 18 months after surgical resection. The present case highlights an unusual phenomenon of the development of an unusual form of adenocarcinoma in an adolescent.

Adenosquamous carcinoma: a case report with immunohistochemical evaluation

The histogenetic origin of adenosquamous carcinoma, a high-grade variant of malignant epithelial neoplasm, has long been debated. We report a case that clearly demonstrated a mucosal surface epithelial origin. This concept was supported through histologic analysis of hematoxylin- and eosin-stained sections, as well as by the pattern of immunohistochemical reactivity with antibodies directed against low and high molecular weight cytokeratins, cell adhesion molecules (CAM 5.2), and carcinoembryonic antigens. The histologic differential diagnosis, biological behavior, and prognosis of adenosquamous carcinoma are also examined.

Urethral caruncle with coexistence of intestinal heterotopia. A case report

Urethral caruncle is one of the benign disorders which occurs frequently after the menopause. We describe a case of urethral caruncle with intestinal heterotopia, in which infiltration by lymphocytes, invagination of the urethral transitional epithelium causing nest formation, lumen formation, hypervascularity as well as teleangiectasia were observed, suggesting the occurrence of metaplasia in the transitional epithelium preceding the intestinal heterotopia. The aetiology and clinical significance of urethral caruncle exhibiting intestinal heterotopia are discussed.

Surface adenosquamous carcinoma of the penis. A report of three cases

Three patients, aged 37, 72, and 74 years, with adenosquamous carcinoma of the penis are described. The duration of disease was 6, 9, and 144 months, respectively. Grossly a firm, white-gray granular exophytic mass was noted (7.6 cm average diameter). Microscopically, a mixed carcinoma showing squamous and glandular elements was present; the squamous component predominated. In two cases the adenocarcinoma was located in the perimeatal area of the glans. The periurethral glands were not involved. The glandular foci were discrete and had minimal admixture with the squamous carcinoma. Mucin material was present in the lumina, apical border, and cytoplasm. Immunohistochemically, cells showed positivity for carcinoembryonic antigen in glandular areas. The squamous cell carcinomas were of the "warty" variant in two cases and of the usual squamous cell type in the other case. In one patient, metastatic adenosquamous carcinoma was noted in one inguinal node and showed mucin secretion. This patient is alive and well 102 months after diagnosis. Another patient is alive with no evidence of disease 12 months after surgery, and the third was lost to follow-up. Adenosquamous carcinomas of the penis are unusual neoplasms probably originating in penile surface epithelium and in embryologically misplaced mucus glands of the perimeatal region of glans mucosa.

Adenocarcinoma of the male urethra with associated nephrogenic metaplasia. Case report and review of the literature

Nephrogenic metaplasia is an uncommon sequela of chronic bladder irritation. The case described herein represents the second reported in the bulbomembranous urethra of the male. Important questions are raised regarding the premalignant potential of nephrogenic metaplasia. A review of the literature on adenocarcinoma of the male urethra and also of nephrogenic metaplasia of the bladder and urethra is presented.

Papillary adenocarcinoma of the male urethra. Case report and review of the literature

Mucinous papillary adenocarcinoma of the bulbous urethra developed in a 40-year-old man with congenital stricture. The tumor appeared as a localized polypoid exophytic mass without evidence of submucosal invasion (Stage 0). The tumor was determined not to be of prostatic origin clinically and by absence of immunoperoxidase staining for prostatic acid phosphatase, prostate specific antigen, and carcinoembryonic antigen. Surgical resection of the urethra revealed extensive squamous and glandular metaplasia (urethritis glandularis) in association with the neoplasm. The mucosa displayed a spectrum of epithelial changes varying from dysplasia to carcinoma in situ, in confirmation of the urethral origin of the tumor. These observations emphasize the close association of metaplastic proliferative lesions and malignancy in the lower urinary tract.