Aggressive course of a rare type of urethral cancer in women

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The article provides a clinical case of urethral cancer in women. Primary urethral carcinomas are rare, less than 1% of all malignant tumors. According to the Rarecare Cancer Surveillance Agency for Europe (RARECARE), urethral cancer in women is 0.6 and 1.6 in men per 1 million people per year. A 56-year-old patient with histologically verified clear cell adenocarcinoma of the proximal urethra was monitored for 18 months. An aggressive course of the tumor process has been shown, which led to the need to perform anterior exenteration of the pelvic organs. The histogenesis of primary clear cell urethral adenocarcinoma has not been definitively determined. The atypical external localization in the described case suggests the periurethral origin of this cancerous tumor from the Skene’s glands. The demonstration of a rare form of urethral cancer, clear cell adenocarcinoma, contributes to the accumulation of knowledge about its histopathology and clinical course, as well as increasing cancer alertness in the treatment of urethral diseases in doctors of any specialty.

About the authors

Olga S. Streltsova

Privolzhskiy Research Medical University

Author for correspondence.
Email: strelzova_uro@mail.ru
ORCID iD: 0000-0002-9097-0267
SPIN-code: 9674-0382

Doctor of Medical Science, Professor, Department of Urology named after E.V. Shakhov

Russian Federation, Nizhnij Novgorod

Katerina E. Yunusova

Privolzhskiy Research Medical University

Email: katyayunusova@yandex.ru
ORCID iD: 0000-0001-9283-0332
SPIN-code: 9211-4897

Candidate of Medical Science, Associate Professor of the Department of Pathological Anatomy

Russian Federation, Nizhnij Novgorod

Valentin N. Krupin

Privolzhskiy Research Medical University

Email: vn.krupin@mail.ru
ORCID iD: 0000-0002-4887-4888

Doctor of Medical Science, Professor, Head of the Department of Urology named after E.V. Shakhov

Russian Federation, Nizhny Novgorod

Vasiliy V. Vlasov

Privolzhskiy Research Medical University

Email: urolog.75@mail.ru
ORCID iD: 0000-0002-9502-4229

Candidate of Medical Science, Associate Professor of the Department of Urology named after E.V. Shakhov

Russian Federation, Nizhnij Novgorod

Anton S. Kuyarov

Privolzhskiy Research Medical University

Email: kuyarov.anton@mail.ru
ORCID iD: 0000-0003-0503-6128

Student

Russian Federation, Nizhnij Novgorod

References

  1. Gatta G, van der Zwan JM, Casali PG, et al. Rare cancers are not so rare: the rare cancer burden in Europe. Eur J Cancer. 2011;47(17):2493-2511. https://doi.org/10.1016/j.ejca.2011. 08.008.
  2. Visser O, Adolfsson J, Rossi S, et al. Incidence and survival of rare urogenital cancers in Europe. Eur J Cancer. 2012;48(4):456-464. https://doi.org/10.1016/j.ejca.2011.10.031.
  3. Swartz MA, Porter MP, Lin DW, Weiss NS. Incidence of primary urethral carcinoma in the United States. Urology. 2006;68(6):1164-1168. https://doi.org/10.1016/j.urology.2006. 08.1057.
  4. Trabelsi A, Abdelkrim SB, Rammeh S, et al. Clear cell adenocarcinoma of a female urethra: A case report and review of the literature. N Am J Med Sci. 2009;1(6):321-323. 3364636.
  5. Champ CE, Hegarty SE, Shen X, et al. Prognostic factors and outcomes after definitive treatment of female urethral cancer: a population-based analysis. Urology. 2012;80(2):374-381. https://doi.org/10.1016/j.urology.2012.02.058.
  6. Gakis G, Witjes JA, Comperat E, et al. EAU guidelines on primary urethral carcinoma. Eur Urol. 2013;64(5):823-830. https://doi.org/10.1016/j.eururo.2013.03.044.
  7. Рич Д.П., Д’Амико Э.В. Онкоурология. – М.: Бином, 2011. – 896с. [Rich DP, D’Amiko EV. Onkourologiya. Moscow: Binom; 2011. 896 p. (In Russ.)]
  8. Клинические рекомендации Европейской ассоциации урологов, 2017. – М.: Медфорум, 2017. – 1224 c. [Clinical recommendations of the European Association of Urology, 2017. Moscow: Medforum, 2017. 1224 p. (In Russ.)]
  9. Ball RY. Pathology and genetics of tumours of the urinary system and male genital organs. Histopathology. 2005;46(5):586-586. https://doi.org/10.1111/j.1365-2559.2005.02096.x.
  10. Mehra R, Vats P, Kalyana-Sundaram S, et al. Primary urethral clear-cell adenocarcinoma: comprehensive analysis by surgical pathology, cytopathology, and next-generation sequencing. Am J Pathol. 2014;184(3):584-591. https://doi.org/10.1016/j.ajpath.2013.11.023.
  11. Weng WC, Wang CC, Ho CH, et al. Clear cell carcinoma of female urethral diverticulum – a case report. J Formos Med Assoc. 2013;112(8):489-491. https://doi.org/10.1016/j.jfma.2012. 07.018.
  12. Satyanarayan A, Redd L, Dyer A, et al. Adenocarcinoma of the urethra with mucinous features. Rev Urol. 2015;17(1):38-41. 4444775.
  13. Scantling D, Ross C, Jaffe J. Primary clear cell adenocarcinoma of a urethral diverticulum treated with multidisciplinary robotic anterior pelvic exenteration. Case Rep Med. 2013;2013:387591. https://doi.org/10.1155/2013/387591.
  14. legalacts.ru [интернет]. Министерство здравоохранения РФ. Клинические рекомендации «Рак уретры» (утв. Минздравом России). 2020 [доступ от 19.05.2020]. Доступ по ссылке: https://legalacts.ru/doc/klinicheskie-rekomendatsii-rak-uretry-utv-minzdravom-rossii/ [legalacts.ru [Internet]. Ministerstvo zdravookhraneniya RF. Klinicheskie rekomendatsii “Rak uretry” (utv. Minzdravom Rossii). 2020 [cited 19 May 2020]. Available from: https://legalacts.ru/doc/klinicheskie-rekomendatsii-rak-uretry-utv-minzdravom-rossii/ (In Russ.)]
  15. Hohenberger P, Kasper B. Die International Rare Cancers Initiative. Forum. 2017;32(1):26-31. https://doi.org/10.1007/s12312- 016-0210-x.
  16. Karnes RJ, Breau RH, Lightner DJ. Surgery for urethral cancer. Urol Clin North Am. 2010;37(3):445-457. https://doi.org/10.1016/j.ucl.2010.04.011.
  17. Rane SR, Ghodke AN, Vishwasrao S. Clear Cell Adenocarcinoma of Female Urethra. J Clin Diagn Res. 2017;11(7): ED01-ED02. https://doi.org/10.7860/JCDR/2017/25261.10127.

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. MRI images of the pelvic organs of patient V., 56 y. o.: a – frontal projection, b – sagittal projection. A tumor with a clear outline is located around the urethra

Download (222KB)
3. Fig. 2. The progress of the operation. Isolation of a tumor located around the urethra (a), excision of the tumor (b) with preservation of the neck the bladder and the distal part of the urethra (c)

Download (269KB)
4. Fig. 3. Macropreparations. The urethra is dissected lengthwise, light tumor masses are visible around the urethral fragment and a lesion of ulceration of the mucous membrane (indicated by an arrow)

Download (127KB)
5. Fig. 4. Histological preparations of the urethra with a tumor: a – the mucous membrane of the urethra, there is no tumor growth (stain hematoxylin-eosin, ×40); b – clear cell carcinoma with invasive growth in the outer layers of the urethra (stain hematoxylin-eosin, ×100); c – clear cell carcinoma of the urethra (stain hematoxylin-eosin, ×200)

Download (505KB)

Copyright (c) 2020 Streltsova O.S., Yunusova K.E., Krupin V.N., Vlasov V.V., Kuyarov A.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).