Urothelial carcinoma of the urethra

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Urothelial carcinoma of the urethra
Diagnosis in short

Urothelial carcinoma and benign prostatic tissue in keeping with urethral urothelial carcinoma. H&E stain. (WC/Nephron)
LM DDx prostatic carcinoma - especially poorly differentiated and urothelial carcinoma-like prostatic carcinoma
Stains GATA3 +ve, p63 +ve, CK5/6 +ve, PSA -ve, PSAP -ve
Grossing notes cystoprostatectomy grossing, TURP grossing
Site urethra - also see prostate (prostate cancer)

Clinical history +/-radiation therapy, bladder cancer
Signs +/-hematuria
Prevalence uncommon
Clin. DDx benign urethral stricture
Treatment cystoprostatectomy/cystectomy or endoscopic resection

Urothelial carcinoma of the urethra is an uncommon epithelial malignancy of the urethra. It may be primary, i.e. arises in the urethra, or secondary (spreads from the bladder or upper genitourinary tract).

Prostatic urothelial carcinoma and urothelial carcinoma of the prostate gland redirect here.

General

Treatment:[4]

  • Cystoprostatectomy - stromal invasion or extensive intraductal involvement.
  • Endoscopic resection and BCG - limited extent without stromal invasion.

Clinical DDx:

  • Benign urethral stricture.

Microscopic

Features:

  • Divided into tumours with:
    1. Stromal invasion.
    2. Without stromal invasion.

Notes:

  • Stromal involvement common ~ 75% of cases.[5]

DDx:

Images

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PROSTATE TISSUE, TRANSURETHRAL RESECTION:
- HIGH-GRADE UROTHELIAL CARCINOMA WITH FOCAL STROMAL INVASION, AND EXTENSIVE
  INTRADUCTAL SPREAD IN FRAGMENTS WITH BENIGN PROSTATIC GLANDS.

See also

References

  1. Novicki, DE.; Gehring, GG. (Jul 1976). "Urethral carcinoma after radiation therapy for mixed prostatic carcinoma.". J Urol 116 (1): 122-3. PMID 933273.
  2. Winters, JC.; Fuselier, HA. (Dec 1992). "Invasive bladder cancer following 125iodine implants.". J Urol 148 (6): 1898-900. PMID 1433634.
  3. Huguet, J. (Oct 2012). "[Prostatic involvement by urothelial carcinoma in patients with bladder cancer and their implications in the clinical practice].". Actas Urol Esp 36 (9): 545-53. doi:10.1016/j.acuro.2012.02.005. PMID 22520044.
  4. 4.0 4.1 Liedberg, F.; Chebil, G.; Månsson, W. (Mar 2007). "Urothelial carcinoma in the prostatic urethra and prostate: current controversies.". Expert Rev Anticancer Ther 7 (3): 383-90. doi:10.1586/14737140.7.3.383. PMID 17338657.
  5. Ichihara, K.; Masumori, N.; Kitamura, H.; Hasegawa, T.; Tsukamoto, T. (Dec 2012). "Clinical outcomes of urothelial carcinoma of the prostate detected in radical cystectomy specimens.". Int J Clin Oncol. doi:10.1007/s10147-012-0508-3. PMID 23250619.