Difference between revisions of "Urothelial carcinoma of the urethra"

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'''Urothelial carcinoma of the urethra''' is uncommon. It may be primary, i.e. arises in the [[urethra]], or secondary (spreads from the bladder or upper genitourinary tract).
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Urothelial carcinoma in prostate - 2 -- high mag.jpg
| Width      =
| Caption    = Urothelial carcinoma and benign prostatic tissue in keeping with urethral urothelial carcinoma. [[H&E stain]]. (WC/Nephron)
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[prostatic carcinoma]] - especially poorly differentiated and [[urothelial carcinoma-like prostatic carcinoma]]
| Stains    = [[GATA3]] +ve, [[p63]] +ve, CK5/6 +ve, [[PSA]] -ve, [[PSAP]] -ve
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  = [[cystoprostatectomy grossing]], [[TURP grossing]]
| Staging    =
| Site      = [[urethra]] - also see [[prostate]] ([[prostate cancer]])
| Assdx      =
| Syndromes  =
| Clinicalhx = +/-radiation therapy, [[bladder cancer]]
| Signs      = +/-[[hematuria]]
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = benign urethral stricture
| Tx        = [[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.  
'''Prostatic urothelial carcinoma''' and '''urothelial carcinoma of the prostate gland''' redirect here.  


==General==
==General==
*May arise secondary to radiation for [[prostate cancer]].<ref name=pmid933273>{{Cite journal  | last1 = Novicki | first1 = DE. | last2 = Gehring | first2 = GG. | title = Urethral carcinoma after radiation therapy for mixed prostatic carcinoma. | journal = J Urol | volume = 116 | issue = 1 | pages = 122-3 | month = Jul | year = 1976 | doi =  | PMID = 933273 }}</ref>
*May arise secondary to radiotherapy for [[prostate cancer]].<ref name=pmid933273>{{Cite journal  | last1 = Novicki | first1 = DE. | last2 = Gehring | first2 = GG. | title = Urethral carcinoma after radiation therapy for mixed prostatic carcinoma. | journal = J Urol | volume = 116 | issue = 1 | pages = 122-3 | month = Jul | year = 1976 | doi =  | PMID = 933273 }}</ref><ref name=pmid1433634>{{Cite journal  | last1 = Winters | first1 = JC. | last2 = Fuselier | first2 = HA. | title = Invasive bladder cancer following 125iodine implants. | journal = J Urol | volume = 148 | issue = 6 | pages = 1898-900 | month = Dec | year = 1992 | doi =  | PMID = 1433634 }}</ref>
*Spreads from the [[urinary bladder]] usually - common.<ref name=pmid22520044>{{Cite journal  | last1 = Huguet | first1 = J. | title = [Prostatic involvement by urothelial carcinoma in patients with bladder cancer and their implications in the clinical practice]. | journal = Actas Urol Esp | volume = 36 | issue = 9 | pages = 545-53 | month = Oct | year = 2012 | doi = 10.1016/j.acuro.2012.02.005 | PMID = 22520044 }}</ref>
*Spreads from the [[urinary bladder]] usually - common.<ref name=pmid22520044>{{Cite journal  | last1 = Huguet | first1 = J. | title = [Prostatic involvement by urothelial carcinoma in patients with bladder cancer and their implications in the clinical practice]. | journal = Actas Urol Esp | volume = 36 | issue = 9 | pages = 545-53 | month = Oct | year = 2012 | doi = 10.1016/j.acuro.2012.02.005 | PMID = 22520044 }}</ref>
*Identified by endoscopic loop biopsy<ref name=pmid17338657>{{Cite journal  | last1 = Liedberg | first1 = F. | last2 = Chebil | first2 = G. | last3 = Månsson | first3 = W. | title = Urothelial carcinoma in the prostatic urethra and prostate: current controversies. | journal = Expert Rev Anticancer Ther | volume = 7 | issue = 3 | pages = 383-90 | month = Mar | year = 2007 | doi = 10.1586/14737140.7.3.383 | PMID = 17338657 }}</ref> or [[TURP]].
*Identified by endoscopic loop biopsy<ref name=pmid17338657>{{Cite journal  | last1 = Liedberg | first1 = F. | last2 = Chebil | first2 = G. | last3 = Månsson | first3 = W. | title = Urothelial carcinoma in the prostatic urethra and prostate: current controversies. | journal = Expert Rev Anticancer Ther | volume = 7 | issue = 3 | pages = 383-90 | month = Mar | year = 2007 | doi = 10.1586/14737140.7.3.383 | PMID = 17338657 }}</ref> or [[TURP]].

Latest revision as of 22:16, 16 February 2016

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

  • UCC in prostate - low mag. (WC/Nephron)

  • UCC in prostate - intermed. mag. (WC/Nephron)

  • UCC in prostate - high mag. (WC/Nephron)

  • UCC in prostate - high mag. (WC/Nephron)

  • UCC in prostate - intermed. mag. (WC/Nephron)

  • UCC in prostate - high mag. (WC/Nephron)

  • UCC in prostate - very high mag. (WC/Nephron)

  • UCC in prostate - intermed. mag. (WC/Nephron)

  • UCC in prostate - high mag. (WC/Nephron)

  • UCC in prostate - very high mag. (WC/Nephron)

Sign out

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.
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