Journal of Pathology and Translational Medicine

Case Study

Sarcomatoid urothelial carcinoma arising in the female urethral diverticulum: Heae Surng Park; J Pathol Transl Med. 2021;55(4):298-302. Published online June 1, 2021; DOI: https://doi.org/10.4132/jptm.2021.04.23

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A sarcomatoid variant of urothelial carcinoma in the female urethral diverticulum has not been reported previously. A 66-year-old woman suffering from dysuria presented with a huge urethral mass invading the urinary bladder and vagina. Histopathological examination of the resected specimen revealed predominantly undifferentiated pleomorphic sarcoma with sclerosis. Only a small portion of conventional urothelial carcinoma was identified around the urethral diverticulum, which contained glandular epithelium and villous adenoma. The patient showed rapid systemic recurrence and resistance to immune checkpoint inhibitor therapy despite high expression of programmed cell death ligand-1. We report the first case of urethral diverticular carcinoma with sarcomatoid features.

Citations

Citations to this article as recorded by

Reprint of: Female Urethral Carcinoma: A contemporary review of the clinicopathologic features, with emphasis on the histo-anatomic landmarks and potential staging issues
Maria Sarah Lagarde-Lenon, Manju Aron
Human Pathology.2023; 133: 126. CrossRef
Female Urethral Diverticula: a Contemporary Narrative Review of Aetiology, Diagnosis, and Treatment
A. U. Nic an Ríogh, S. Monagas Arteaga, L. Tzelves, M. Karavitakis, A. K. Nambiar
Current Bladder Dysfunction Reports.2022; 17(4): 250. CrossRef
Female urethral carcinoma: a contemporary review of the clinicopathologic features, with emphasis on the histoanatomic landmarks and potential staging issues
Maria Sarah Lagarde-Lenon, Manju Aron
Human Pathology.2022; 129: 71. CrossRef

Case Reports

Cytologic Findings of Clear Cell Adenocarcinoma of the Urethra: A Case Report: Jee-Young Han, Kyu-Ho Kim, Lucia Kim, Suk-Jin Choi, In-Suh Park, Joon-Mee Kim, Young-Chae Chu, Sang-Min Yoon; Korean J Pathol. 2012;46(2):210-214. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.210

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Abstract PDF

Clear cell adenocarcinoma of the urethra is a rare disease entity with an uncertain histogenesis. Here, we present a case of primary clear cell adenocarcinoma of the female urethra with its cytological findings. A 54-year-old woman presented with a painless gross hematuria lasting 3 months. On vaginal sonography, there was a sausage-like, elongated mass in the urethra, measuring 3.8×4.3 cm. The voided urine cytology revealed small clusters of rounded or papillary cells. The necrotic debris and inflammatory cells were present within some clusters of tumor cells. These tumor cells were enlarged and had abundant clear or granular cytoplasm with cytoplasmic vacuoles. The nucleus was granular and contained vesicular chromatin with prominent nucleoli. The hobnail cells and hyaline globules were also present as in a histologic section. The histologic findings were compatible with clear cell adenocarcinoma. The tumor showed distinctive cytological features. Cytologically, however, it is necessary to make a differential diagnosis from other adenocarcinoma or high-grade urothelial carcinoma.

Citations

Citations to this article as recorded by

Cytological and histological findings of upper tract mucinous urothelial carcinoma with clear cell component: A case report and review of literature
Go Kobayashi, Naohiro Uraoka, Kazuhiro Sentani, Jun Shibata, Ryosuke Nobuhiro, Yoichi Saito, Daiki Taniyama, Masanori Hanamoto, Hiroyuki Nose, Naohide Oue
Diagnostic Cytopathology.2022;[Epub] CrossRef
Presentación de reporte de caso: adenocarcinoma de célula clara de uretra
Nataly González, Yuly Ramirez, Jose Szelezsán, Daniel Rojas
Revista Urología Colombiana / Colombian Urology Journal.2018; 27(02): 191. CrossRef
Clear Cell Adenocarcinoma of the Urethra: Review of the Literature
Anthony Kodzo-Grey Venyo
International Journal of Surgical Oncology.2015; 2015: 1. CrossRef

Primary Malignant Melanoma of the Male Urethra.: Seung Wook Lee, Eun Kyung Kim, Won Mi Lee, Jung Man Jo, Tag Keun Yoo, Jeong Yoon Kang; Korean J Pathol. 2010;44(6):662-665.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.662

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Abstract PDF: Primary malignant melanoma occurring within the male urethra is very rare. Here we report a case of malignant melanoma of the urethra in a 74-year-old man. He presented with asymptomatic gross hematuria for 5 months. His glans penis and adjacent penile skin had become discolored black 10 years ago. Cystourethroscopy showed a smooth oval-shaped elevated mass in the fossa navicularis. There were no abnormal findings in the proximal urethra and urinary bladder. Computed tomography did not detect any inguinal lymph node enlargement or distant metastases. The patient underwent partial penectomy and ilioinguinal lymph node dissection. Grossly, the distal urethra revealed an ovoid pigmented nodule, that measured 1 x 0.5 cm. Microscopic findings showed a nodular malignant melanoma arising in the urethral mucosa with pagetoid spread to the epidermis of the glans penis. There were no recurrences over a period of 12 months after surgery without chemotherapy. This is the second case of a primary malignant melanoma of the male urethra in Korea.

Female Urethral Adenocarcinoma Possibly Arising in Paraurethral Gland: A case report.: Hyun Hee Lee, Hyun Ee Yim, Nam Hoon Cho, Chanil Park; Korean J Pathol. 1995;29(3):399-401.

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Abstract PDF: Female urethral adenocarcinoma is one of the rare tumors. It has been thought to arise in the paraurethral Skene's gland, the transitional epithelium of proximal urethra or the urethral diverticulum. This is to report a urethral adenocarcinoma developed in a 51 year-old patient who had a past history of suburethral abscess 7 years ago, and to discuss its possible histogenetic origin. The tumor was located in the urethral wall and revealed a centrifugal growth pattern toward the anterior wall of uterus and vagina and an upward extension to the bladder neck. The tumor was composed mostly of well differentiated adenocarcinoma and partly of signet ring cell carcinoma. The urethral and bladder epithelia were well preserved without cancerous or precancerous changes, and there was no urethritis glandularis nor cystitis glandularis. The secretary material of the neoplastic glands was weakly positive for prostate specific antigen (PSA) and prostate specific acid phosphatase (PSAP). Although the tumor cells themselves were not reactive to PSA and PSAP, the histologic findings suggest that the urethral adenocarcinoma arises in the paraurethral Skene's gland which had probably been the site of abscess in this patient.

Leiomyoma of the Female Urethra: A case report.: Kyoung Mee Kim, Anhi Lee, Sang In Shim; Korean J Pathol. 1995;29(5):684-686.

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Abstract: Leiomyomas are benign tumors of smooth muscle origin and are very rare in the female genital tract. To date, approximately 35 cases of urethral leiomyoma have been reported in the literature. A 34-year-old woman presented with a 3-year history of a mass at the urethral meatus. Physical examination showed 2 x 1.5 cm lump at the urethral meatus, posterior lip. Histologically the tumor was mainly composed of benign cigar shaped smooth muscle izells which were arranged in interlacing fascicles without cellular atypia or mitosis. Immunohistochemistry confirmed leiomyoma with positive staining for vimentin, desmin and muscle specific actin.

Mucoid Cyst of Penile Skin: A case report.: Joong Seok Seo, Yong Wook Park, Kye Yong Song, Sae Chul Kim; Korean J Pathol. 1990;24(1):82-84.

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Abstract PDF: A rare case of mucoid cyst of the penile skin in a 23 year-old man is reported, which has been presented as a movable, superficial and no tender nodule, measuring 0.8 cm in maximum diameter at the periurethral meatus of the glans for 6 months. This nodule was removed by simple excision and proved to be a mucoid cyst of penile skin, which was lined by pseudostratified columnar epithelium with occasional mucous epithelium and glands, suggesting its origin is most likely from sequestrated periurethral glands.

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