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IJU Case Reports Nov 2023The histological types of urethral cancer are mainly squamous cell or transitional cell carcinoma. Neuroendocrine tumor is extremely a rare type of urethral cancer.
INTRODUCTION
The histological types of urethral cancer are mainly squamous cell or transitional cell carcinoma. Neuroendocrine tumor is extremely a rare type of urethral cancer.
CASE PRESENTATION
A 72-year-old man visited with an erythema at the external urethral meatus. After 3 months, a 1-cm reddish solid tumor was found on the external urethral meatus. He had a history of bladder cancer (pTa with carcinoma in situ), including the prostatic urethra, and underwent radical cystectomy with urethrectomy and ileal conduit construction 11 years ago. After 3 months, a 1-cm reddish solid tumor was found on the external urethral meatus. The pathological diagnosis was a neuroendocrine tumor. Partial penectomy was performed.
CONCLUSION
Small cell neuroendocrine tumor could occur on urethral remnant after radical cystectomy with urethrectomy for urothelial cancer. Inspection of the penis and urethral meatus is important during regular follow-up of patients after radical cystectomy.
PubMed: 37928310
DOI: 10.1002/iju5.12639 -
Asian Journal of Surgery Jun 2024
Review
Topics: Humans; Penile Neoplasms; Male; Urinary Bladder Neoplasms; Aged; Middle Aged
PubMed: 38555212
DOI: 10.1016/j.asjsur.2024.03.095 -
Cureus Dec 2023Penile metastases from urothelial carcinoma are rare (1-8%). They most often (65%) occur within 18 months of diagnosis of the primary lesion and their prognosis is poor,...
Penile metastases from urothelial carcinoma are rare (1-8%). They most often (65%) occur within 18 months of diagnosis of the primary lesion and their prognosis is poor, with survival rarely exceeding 20 months. Treatment of cavernous metastases is multidisciplinary. The best results in terms of overall survival have been obtained with amputation of the penis combined with chemotherapy. We present a case of a 62-year-old male who presented with a metastasis of the penis. This was confirmed by MRI and biopsy, which confirmed the urothelial origin of the metastasis. The patient had undergone radical cystoprostatectomy for an invasive bladder tumor six months earlier. The patient died 10 days after the biopsy due to a significant deterioration in his general condition and the onset of consciousness disorders.
PubMed: 38239540
DOI: 10.7759/cureus.50767 -
Academic Radiology May 2024The purpose of our study was to evaluate pretreatment prostate quantitative magnetic resonance imaging (MRI) measurements and clinical characteristics in predicting...
RATIONALE AND OBJECTIVES
The purpose of our study was to evaluate pretreatment prostate quantitative magnetic resonance imaging (MRI) measurements and clinical characteristics in predicting genitourinary (GU) toxicity after radiotherapy (RT) for prostate cancer.
MATERIALS AND METHODS
In this single-institution retrospective cohort study, we evaluated patients with prostate adenocarcinoma who underwent MRI within 6 months before completing definitive RT and follow-up information in our GU toxicity database from June 2016 to February 2023. MRI measurements included quantitative urethra, prostate, and bladder measurements. GU toxicity was physician-scored using the Common Terminology Criteria for Adverse Events (CTCAE v4.0) with acute toxicity defined as ≤180 days and late defined as >180 days. Multivariable logistic regression model was constructed for grade ≥2 acute toxicity and Cox proportional hazards regression for late toxicity, adjusted for clinical factors and RT method.
RESULTS
A total of 361 men (median age 68 years, interquartile range [IQR] 62-73) were included; 14.4% (50/347) men experienced grade ≥2 acute toxicity. Brachytherapy (odds ratio [OR]: 2.9, 95% confidence interval [CI]: 1.5-5.8), P < 0.01) was associated with increased odds of acute GU toxicity, and longer MUL (OR: 0.41 [95%CI: 0.18-0.92], P = 0.03) with decreased odds. Median follow-up for late toxicity was 15.0 months (IQR: 9.0-28.0) with approximately 88.7% and 72.0% patients free of toxicity at 1 and 3 years, respectively. Only longer prostatic urethral length (hazard ratio [HR]: 1.6, 95%CI: 1.2-2.1, P < 0.01) was associated with increased risk of late GU toxicity, notably urinary frequency/urgency symptoms (HR: 1.7 [95%CI: 1.3-2.3], P < 0.01).
CONCLUSION
Longer prostatic urethral length measured on prostate MRI is independently associated with higher risk of developing late grade ≥2 GU toxicity after radiation therapy for prostate cancer. This pretreatment metric may be potentially valuable in risk-stratification models for quality of life following prostate RT.
Topics: Humans; Male; Prostatic Neoplasms; Aged; Retrospective Studies; Magnetic Resonance Imaging; Middle Aged; Urethra; Radiation Injuries; Brachytherapy; Prostate; Adenocarcinoma
PubMed: 37858506
DOI: 10.1016/j.acra.2023.09.004 -
European Urology Oncology Jun 2024Penile squamous cell carcinoma (PSCC) is characterised by stepwise lymphatic dissemination. Skip metastases (SkMs) are rare metastases in the corpus cavernosum or...
BACKGROUND
Penile squamous cell carcinoma (PSCC) is characterised by stepwise lymphatic dissemination. Skip metastases (SkMs) are rare metastases in the corpus cavernosum or spongiosum without continuity to the primary tumour or its resection site.
OBJECTIVE
To assess the distinct pattern of spread in SkM patients and the effect of SkM on prognosis.
DESIGN, SETTING, AND PARTICIPANTS
We conducted a retrospective analysis of patients with SkM PSCC at ten high-volume international referral centres between January 2006 and May 2022.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
We evaluated histopathological data, primary lymph node (LN) staging, and metastatic spread. We included a cohort of patients matched for pT stage, LN status, and grade who did not have SkM (SkM) to compare the SkM prognosis and predictive value for cancer-specific mortality (CSM).
RESULTS AND LIMITATIONS
Among the 63 SkM patients who met our inclusion criteria, the SkM diagnosis was synchronous in 54.0% and metastases were mostly located in the corpus cavernosum. SkM was symptomatic in 14% of cases, was detected on imaging in 32%, and was found incidentally on pathological examination in 27%. Fifty-one patients (81%) presented with positive LNs and 28 (44%) developed distant metastases. Seven patients (11%) presented with or developed distant metastasis without displaying any LN involvement. The 2-yr cancer-specific survival estimates were 36% (95% confidence interval [CI] 25-52%) for SkM and 66% (95% CI 55-80%) for matched SkM patients (p < 0.001). On multivariable Cox regression analysis, SkM presence was an independent predictor for higher CSM (hazard ratio 2.05, 95% CI 1.06-4,12; p = 0.03).
CONCLUSIONS
PSCC-related SkM is associated with aggressive disease behaviour and poor survival outcomes. Palpation of the entire penile shaft is essential, and distant staging is recommended in patients suspected of having SkM owing to the tendency for distant metastatic spread.
PATIENT SUMMARY
We investigated outcomes for patients with cancer of the penis who had metastases in the tissues responsible for erection. We found that metastases in this location were associated with poor prognosis, even in the absence of more typical spread of cancer via the lymph nodes.
Topics: Humans; Penile Neoplasms; Male; Retrospective Studies; Carcinoma, Squamous Cell; Prognosis; Middle Aged; Aged; Lymphatic Metastasis; Adult; Neoplasm Staging
PubMed: 37813746
DOI: 10.1016/j.euo.2023.09.005 -
Cancer Research and Treatment Jan 2024This study aimed to evaluate the molecular features of clear cell adenocarcinoma (CCA) of the urinary tract and investigate its pathogenic pathways and possible...
PURPOSE
This study aimed to evaluate the molecular features of clear cell adenocarcinoma (CCA) of the urinary tract and investigate its pathogenic pathways and possible actionable targets.
MATERIALS AND METHODS
We retrospectively collected the data of patients with CCA between January 1999 and December 2016; the data were independently reviewed by two pathologists. We selected five cases of urinary CCA, based on the clinicopathological features. We analyzed these five cases by whole exome sequencing (WES) and subsequent bioinformatics analyses to determine the mutational spectrum and possible pathogenic pathways.
RESULTS
All patients were female with a median age of 62 years. All tumors were located in the urethra and showed aggressive behavior with disease progression. WES revealed several genetic alterations, including driver gene mutations (AMER1, ARID1A, CHD4, KMT2D, KRAS, PBRM1, and PIK3R1) and mutations in other important genes with tumor-suppressive and oncogenic roles (CSMD3, KEAP1, SMARCA4, and CACNA1D). We suggest putative pathogenic pathways (chromatin remodeling pathway, mitogen-activated protein kinase signaling pathway, phosphoinositide 3-kinase/AKT/mammalian target of rapamycin pathway, and Wnt/β-catenin pathway) as candidates for targeted therapies.
CONCLUSION
Our findings shed light on the molecular background of this extremely rare tumor with poor prognosis and can help improve treatment options.
Topics: Humans; Female; Middle Aged; Male; Adenocarcinoma, Clear Cell; Kelch-Like ECH-Associated Protein 1; Urethra; Phosphatidylinositol 3-Kinases; Retrospective Studies; NF-E2-Related Factor 2; Mutation; DNA Helicases; Nuclear Proteins; Transcription Factors
PubMed: 37697729
DOI: 10.4143/crt.2023.577 -
Histopathology Apr 2024Primary mucinous adenocarcinoma of the urethra represents an extremely rare entity. We sought to characterise further these tumours' clinicopathological,...
AIM
Primary mucinous adenocarcinoma of the urethra represents an extremely rare entity. We sought to characterise further these tumours' clinicopathological, immunohistochemical and molecular features.
METHODS AND RESULTS
Thirty-five cases were identified, occurring in 18 males and 17 females. The mean age at diagnosis was 65 years (28-89 years). The main presentation symptoms were haematuria and urinary outlet obstruction. Microscopic analysis revealed that all 35 tumours have stromal dissection by mucin. Ten tumours showed villoglandular dysplasia, nine showed mucinous metaplasia, two showed adenocarcinoma in situ and four showed signet ring cell features. All tumours were immunopositive for CEA, while immunonegative for nuclear β-catenin; 19 of 23 (83%) expressed high molecular weight cytokeratin; 19 of 33 (58%) CK7; 28 of 34 (82%) CK20; 32 of 35 (91%) CDX2; 22 of 27 (81%) cadherin-17 (CDH-17); 26 of 29 (90%) SATB2; and one of 31 (3%) GATA3. Mismatch repair gene products, including MLH1, PMS2, MSH2 and MSH6, were immunopositive, suggesting the MSI-low genotype of mucinous adenocarcinoma of the urethra. BRAF V600E and ALK rearrangements were not detected. During the mean follow-up of 20 months, nine patients either developed distant metastasis or succumbed to the illness.
CONCLUSION
Our study, encompassing the most extensive series of 35 cases of primary mucinous adenocarcinoma of the urethra, provides crucial insights into its precise diagnosis, management and potential targeted treatments. We found a greater CDX2, SATB2 and CDH17 sensitivity in these urethral tumours for the first time, to our knowledge. We identified characteristics such as an MSI-low profile, non-V600E BRAF mutations and an absence of ALK rearrangements.
Topics: Male; Female; Humans; Aged; Proto-Oncogene Proteins B-raf; Urethra; Biomarkers, Tumor; Adenocarcinoma, Mucinous; Transcription Factors; Receptor Protein-Tyrosine Kinases
PubMed: 38114291
DOI: 10.1111/his.15118 -
International Journal of Urology :... Mar 2024To assess whether 5-year overall survival (OS) of squamous cell carcinoma of the penis (SCCP) patients differs from age-matched male population-based controls.
PURPOSE
To assess whether 5-year overall survival (OS) of squamous cell carcinoma of the penis (SCCP) patients differs from age-matched male population-based controls.
METHODS
We relied on the Surveillance Epidemiology and End Results database (2004-2018) to identify newly diagnosed (2004-2013) SCCP patients. For each case, we simulated an age-matched control (Monte Carlo simulation), relying on the Social Security Administration (SSA) Life Tables with 5 years of follow-up. We compared OS between SCCP patients and population-based controls in a stage-specific fashion. Smoothed cumulative incidence plots displayed cancer-specific mortality (CSM) versus other-cause mortality (OCM).
RESULTS
Of 2282 SCCP patients, the stage distribution was as follows: stage I 976 (43%) versus stage II 826 (36%) versus stage III 302 (13%) versus stage IV 178 (8%). At 5 years, OS of SCCP patients versus age-matched population-based controls was as follows: stage I 63% versus 80% (Δ = 17%), stage II 50% versus 80% (Δ = 30%), stage III 39% versus 84% (Δ = 45%), stage IV 26% versus 87% (Δ = 61%). At 5 years, CSM versus OCM in SCCP patients according to stage was as follows: stage I 12% versus 24%, stage II 22% versus 28%, stage III 47% versus 14%, and stage IV 60% versus 14%.
CONCLUSION
SCCP patients exhibit worse OS across all stages. The difference in OS at 5 years between SCCP and age-matched male population-based controls ranged from 17% to 61%. At 5 years, CSM accounted for 12% to 60% of all deaths, across all stages.
Topics: Humans; Male; Penile Neoplasms; Penis; SEER Program
PubMed: 38014575
DOI: 10.1111/iju.15346 -
Schweizer Archiv Fur Tierheilkunde Oct 2023This case series describes the clinical course of ocular and non-ocular squamous cell carinoma (SCC) in the Haflinger horse and is intended to raise awareness of the...
This case series describes the clinical course of ocular and non-ocular squamous cell carinoma (SCC) in the Haflinger horse and is intended to raise awareness of the high recurrence rate and tendency to metastasize. Eight Haflingers with histologically confirmed SCC were included, five ocular and three non-ocular, who were presented at the Institut Suisse de Médecine Équine (ISME) Bern between July 2015 and January 2022. The ocular SCC cases were all presented because of an apparent mass, which in most cases was post-treatment recurrence. The occurrence of recurrences was observed between 3 weeks and 16 years after initial therapy. Four of five Haflingers with ocular SCC had an enucleation, three of which were clinically normal at the time of the completion of this study, one case was euthanized due to confirmed metastases and one due to lameness. The result of enucleations for therapy of ocular SCC was good if no metastases occurred. Of the three non-ocular SCC cases, only one case, a penile SCC, had an apparent mass. Therapy was initiated in this case, while the other two cases were euthanized shortly after diagnosis due to the poor prognosis of SCC in the appropriate locations (maxillary sinus, mandible). Metastases occurred three and two years after removal of the primary tumor in ocular SCC in the scapula, liver and lungs and in non-ocular SCC from the penis to the nostrils. Since a postmortem pathological examination was not carried out on all Haflingers, further metastases cannot be ruled out. Haflingers with SCC should be monitored by a veterinarian over the long term, as recurrences and/or metastases can still occur years later.
Topics: Male; Horses; Animals; Eye Neoplasms; Carcinoma, Squamous Cell; Epithelial Cells; Penis; Horse Diseases
PubMed: 37822247
DOI: 10.17236/sat00406 -
Cureus Mar 2024Cancer of the penis is a rare tumor that occurs in the elderly. Because of its rarity, it is often not diagnosed early, and its treatment poses difficulties for...
Cancer of the penis is a rare tumor that occurs in the elderly. Because of its rarity, it is often not diagnosed early, and its treatment poses difficulties for practicing oncologists. We report the case of an elderly patient treated for locally advanced squamous cell carcinoma (SCC) of the penis, with a review of the literature. A 71-year-old man, who had been complaining of pruritus on the penis two years ago, presented with an ulcerated lesion on the prepuce and the glans. A biopsy of the lesion with pathological study showed a SCC of the penis. Pelvic MRI showed tumor thickening centered on the glans of the penis, infiltrating the fascia and the spongy urethra with discrete upstream dilatation and bilateral inguinal adenomegaly. CT scan of the neck, chest, abdomen, and pelvis showed no secondary localizations. Treatment initially consisted of carcinological surgery by a partial penectomy with bilateral inguinal lymph node dissection. The tumor was therefore classified as pT3N3M0. A PET CT scan performed later was in favor of local and regional recurrence. Surgery was not feasible, so concomitant chemo-radiotherapy was indicated at a total dose of 70 Gy in 35 fractions of 2 Gy concomitantly with platinum-based chemotherapy, withgood evolution.
PubMed: 38681381
DOI: 10.7759/cureus.57163