bromochloroacetic-acid and Urethral-Neoplasms

Pseudosarcomatous myofibroblastic proliferation of the genitourinary tract is rare and may develop after trauma or spontaneously. The aim of this study was to characterize further the clinicopathological features of these lesions and to examine their relationship to inflammatory myofibroblastic tumour (IMT).. Twenty-seven cases of pseudosarcomatous myofibroblastic proliferation were analysed. There were seven males and 20 females; median age was 37 years (range 16-88). Most lesions were from the bladder (n = 21), while others were in the urethra, vulva, vagina, rectum and retrovesical space. Median tumour size was 30 mm (range 6-120 mm). Seven cases (25%) had a history of prior trauma or surgery. Three cases recurred locally but not destructively. The tumours had fasciitis-like features including bland spindle cells with evenly distributed chromatin, admixed inflammatory cells (mainly lymphocytes) and often a myxoid stroma. Immunohistochemistry showed positivity for smooth muscle actin in 14/20 cases, keratin in 8/19, desmin in 7/20 and anaplastic lymphoma kinase (ALK) in 10/21 cases. Fluorescent in situ hybridization was performed in six ALK+ cases; all were negative for ALK gene rearrangement.. Pseudosarcomatous myofibroblastic proliferations of the genitourinary tract may show ALK immunopositivity but do not show consistent ALK rearrangement. Given subtle morphological differences and more consistently benign behaviour, their relationship to inflammatory myofibroblastic tumour at other sites remains uncertain.

Topics: Actins; Adolescent; Adult; Aged; Aged, 80 and over; Anaplastic Lymphoma Kinase; Desmin; Female; Fibroblasts; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Keratins; Male; Middle Aged; Muscle, Smooth; Myofibroma; Protein-Tyrosine Kinases; Receptor Protein-Tyrosine Kinases; Sarcoma; Urethral Neoplasms; Urinary Bladder Neoplasms

We here report a very rare case of female urethral adenocarcinoma. A 77-year-old woman presented with urinary retention. Cystoscopy showed a urethral tumor and the biopsy material showed adenocarcinoma. Macroscopically, the tumor measuring 3.0 x 3.0 x 2.4 cm was predominantly observed around the periurethral area on the proximal side. Histologically, patterns of columnar/mucinous adenocarcinoma, clear cell adenocarcinoma and papillary/micropapillary carcinoma were observed, but there was no evidence of a cribriform pattern. Immunohistochemically, neoplastic cells of at least one of three components were positive for CK7 and CK20 or CA125. We suggest that female urethral adenocarcinoma with a histologically and immunohistochemically heterogeneous phenotype may originate from cells within urethral or paraurethral tissue, such as urethritis glandularis or intestinal metaplastic epithelium and Mullerian tissue.

Topics: Adenocarcinoma; Aged; CA-125 Antigen; Female; Humans; Immunochemistry; Keratin-20; Keratin-7; Keratins; Phenotype; Urethral Neoplasms

Urethral adenomatous polyps with prostatic epithelium (also known as benign prostatic epithelial polyps [BPEPs]) are a documented cause of hematuria, dysuria, and hematospermia, conditions that may prompt cytologic evaluation of urine.. The urine cytologic test findings in 5 cases of biopsy-proven BPEPs and in 1 case of prostatic ductal adenocarcinoma (PDA) that presented as a urethral polyp were retrospectively evaluated. Immunocytochemical stain for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and high-molecular-weight cytokeratin (34betaE12) were used in evaluation of the lesions.. In 4 of 5 cases of BPEPs, clusters of bland columnar cells with uniform, oval nuclei were seen. Positive immunostaining for PSA and PAP confirmed the prostatic origin of the clusters in 2 cases. One urine sample contained abundant goblet cells and extracellular mucin, consistent with intestinal metaplasia coexisting in the bladder biopsy specimen. The urine sample in the fifth case of BPEPs contained no columnar cells. The last case had multiple urine cytologic evaluations that demonstrated PSA-positive, malignant-appearing clusters of columnar cells. A biopsy specimen of the polyps was described as a high-grade prostatic intraepithelial neoplasm in adenomatous polyp. However, in this patient, PDA was diagnosed on transurethral resection of the prostate specimen 4 years after the initial urine cytologic test.. Benign prostatic epithelial polyps should be considered in the differential diagnosis of clusters of columnar cells in urine cytologic testing. Cells with malignant nuclear features should instigate a careful search for a (prostatic) neoplasm, which may present as urethral polyps (e.g., PDA). Stains for PSA or PAP are useful adjuncts in differential diagnosis of this condition.

Topics: Acid Phosphatase; Adenocarcinoma; Adenomatous Polyps; Adult; Aged; Diagnosis, Differential; Humans; Keratins; Male; Middle Aged; Prostate-Specific Antigen; Prostatic Neoplasms; Urethral Neoplasms; Urine

Female urethral adenocarcinoma is extremely rare and more than one tissue of origin has been suggested other than the Skene's gland. Immunohistochemistry with cytokeratins (CK) 7 and 20 is used to define the origin of the tumor.. A 72-year-old woman presented with a 2-cm polypoid tumor at the external urethral meatus and bleeding. Wide local excision and bilateral inguinal lymphadenectomy were performed. Postoperative convalescence was uneventful. It was a poorly differentiated mucinous adenocarcinoma without direct urothelial involvement. There were focal areas of intestinal metaplasia. The tumor cells were positive for CK 7 and 20 and negative for prostate-specific antigen.. This case provides supportive evidence that mucinous urethral adenocarcinoma may arise from malignant transformation of urethritis glandularis.

Topics: Adenocarcinoma; Aged; Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratin-7; Keratins; Urethral Neoplasms; Urethritis

Penile metastases from prostate cancer are rare and are usually a manifestation of wide-spread cancer dissemination. Isolated urethral metastases form a small fraction of these cases, have a longer survival rate and may represent spread by implantation following instrumentation. We report a case of prostatic carcinoma presenting with an isolated metastasis to the penile urethra after catheterisation and transurethral prostatectomy. The primary tumor had a prominent intraductal component whose architectural features were mimicked in the metastasis. The possible mechanisms of spread and the diverse appearances of cancer associated with an intraductal component are discussed.

Topics: Aged; Carcinoma; Humans; Immunohistochemistry; Keratins; Male; Prostate-Specific Antigen; Prostatic Neoplasms; Urethral Neoplasms

A case of small cell carcinoma arising in the outer urethral orifice is presented. The resected tumor showed a proliferation of small round or fusiform neoplastic cells in the submucosa. Tumor cells were arranged in sheets or a trabecular manner and possessed markedly hyperchromatic nuclei with a high N:C ratio, closely resembling small cell carcinoma of the lung. Characteristically, pagetoid intraepithelial spreading could be identified. However, there was no evidence of in situ transitional cell carcinoma and adeno- or squamous cell carcinoma components anywhere. Ultrastructurally, each tumor cell contained only a few membrane-bound cored granules measuring 60-100 nm, which were compatible with neurosecretory granules, and desmosome-like intercellular attachments, but lacked aggregated microfilaments. By immunohistochemical examination, tumor cells were positive for epithelial markers, such as cytokeratin and epithelial membrane antigen, and neuron specific enolase, but negative for any other neuro-endocrine markers. Extensive systemic examination failed to show the primary site to be other than the outer urethral orifice. These findings indicate that the current tumor is a small cell carcinoma with neuro-endocrine differentiation arising from the outer urethral orifice.

Topics: Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Small Cell; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Microscopy, Electron; Mucin-1; Phosphopyruvate Hydratase; Urethral Neoplasms

We present a case of tubular adenomatous metaplasia (nephrogenic adenoma) arising within a urethral diverticulum in a woman complaining of a vaginal mass with dyspareunia. This lesion, which uncommonly affects the urethra, may clinically manifest as a gynecologic condition and mimic a low-grade adenocarcinoma on pathologic assessment. Criteria for diagnosis and current concepts of pathogenesis are discussed. Our findings, including an immunocytochemical work-up, support the concept of a reactive metaplastic response rather than nephrogenic differentiation.

Topics: Adenoma; Adult; Female; Humans; Immunohistochemistry; Keratins; Metaplasia; Pregnancy; Pregnancy Complications, Neoplastic; Urethral Neoplasms