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Urethral Carcinoma

Prostatic Urethral Cancer


Presentation

  • More than a year after presentation, a primary tumour, located distally on the penis, was diagnosed. A discussion of urethral carcinoma as well as inguinal lymph-node metastasis of unknown primary tumour is presented.[ncbi.nlm.nih.gov]
  • METHODS: A retrospective chart review was done over a 12-year period of patients presenting with urethral cancer to the Johns Hopkins Hospital.[ncbi.nlm.nih.gov]
  • We present 6 patients who underwent such organ-sparing surgery. METHODS: Six selected cases (4 penile and 2 urethral) are presented with operative photographs and pertinent data.[ncbi.nlm.nih.gov]
  • The following discussion presents a unique case of urethral carcinoma (adenocarcinoma) metastatic to bone and reviews the literature regarding this condition.[ncbi.nlm.nih.gov]
  • A patient who had previously undergone ileal neobladder with Studer technique presented an urethral recurrence of a transitional cell carcinoma.[ncbi.nlm.nih.gov]
Perineal Pain
  • It usually manifests in the fifth decade of life. urethral bleeding palpable urethral mass obstructive voiding symptoms perineal pain The histologic types are transitional cell carcinoma in 55%, squamous cell carcinoma in 21.5%, and adenocarcinoma in[radiopaedia.org]
  • pain Palpable suprapubic mass (advanced cases) Features of uremia Constitutional symptoms : anorexia, weight loss, fatigue Metastatic symptoms Enlarged lymph nodes Liver : right upper quadrant pain, hepatomegaly, jaundice, ascites Lungs : dyspnea, cough[amboss.com]
Hemianopsia
Homonymous Hemianopsia
Cognitive Deficit
  • However, considering cognitive deficits after WBRT and the better results of radiosurgery, radiosurgery would play a more important role for the treatment of metastatic brain tumors.[bmccancer.biomedcentral.com]
Hematuria
  • The fourth patient presented with painless hematuria and had a cystoscopy and biopsy of urethral polyps. All patients were treated surgically by sequential distal urethrectomy and various reconstructive procedures.[ncbi.nlm.nih.gov]
  • In women, the usual presentation is urinary retention and hematuria. Clear cell variety of adenocarcinoma is a rarer entity which usually has a better prognosis than other variants. Lymph node metastasis is seen in about 30%of urethral cancers.[cancerjournal.net]
  • As with this patient, many cases of urethral cancer develop in patients whose original cancer was in the urinary bladder, with their urethral cancer developing some time after treatment is complete. 2 Patients present most often with hematuria or dysuria[oncologynurseadvisor.com]
  • Patients often present with painless gross hematuria or irritative voiding symptoms, although some cases are incidentally detected ( microscopic hematuria on urinalysis ).[amboss.com]
Dysuria
  • As with this patient, many cases of urethral cancer develop in patients whose original cancer was in the urinary bladder, with their urethral cancer developing some time after treatment is complete. 2 Patients present most often with hematuria or dysuria[oncologynurseadvisor.com]
  • […] to void (caused by urethral stricture) Frequent urination and increased nighttime urination (nocturia) Hardening of tissue in the perineum, labia, or penis Itching Incontinence Pain during or after sexual intercourse (dyspareunia) Painful urination (dysuria[healthcommunities.com]
  • Postoperatively, she is doing very well and currently denies any dysuria or hematuria. After a discussion with her multi-modality team, she declines any further surgical options.[oncolink.org]
  • G1: well differentiated G2: moderately differentiated G3: poorly to undifferentiated Signs and Symptoms of Urethral Carcinoma Urethral bleeding, dysuria, frequency, urinary retention, palpable tumor or induration on pelvic examination.[urology-textbook.com]
Urethral Bleeding
  • Obstructive symptoms are common in more proximal lesions, while urethral bleeding and palpation of a mass herald more distal lesions ( Figure 112-8 ).[ncbi.nlm.nih.gov]
  • It usually manifests in the fifth decade of life. urethral bleeding palpable urethral mass obstructive voiding symptoms perineal pain The histologic types are transitional cell carcinoma in 55%, squamous cell carcinoma in 21.5%, and adenocarcinoma in[radiopaedia.org]
  • Greater than 95% of men are symptomatic with symptoms including: urethral bleeding, palpable urethral mass or obstructive voiding.[bradyurology.blogspot.com]
  • G1: well differentiated G2: moderately differentiated G3: poorly to undifferentiated Signs and Symptoms of Urethral Carcinoma Urethral bleeding, dysuria, frequency, urinary retention, palpable tumor or induration on pelvic examination.[urology-textbook.com]
Urethral Discharge
  • discharge and swelling Advanced cases of urethral cancer may produce swollen lymph nodes in the groin.[healthcommunities.com]
  • Differential Urethral cancer if blood is present with urethral discharge think urethral cancer Evaluation Intravenous pyelography (IVP) and cystoscopy Alternative modalities include ultrasonography and CT scan CT urography is a relatively new technique[medbullets.com]
  • discharge A mass may be palpable along the urethra (bimanual examination in women).[amboss.com]
Overflow Incontinence
  • About 30% of patients present with: pain difficulty in urination frequent micturition urinary retention or overflow incontinence Early stage urethral tumors may present as a papillary growth within the urethra or as a ulcerative lesion.[oncolink.org]

Workup

  • C 18 Complete blood count, blood chemistry tests, liver function tests, chest radiography, and CT or magnetic resonance imaging of the abdomen and pelvis should be included in the metastatic workup for invasive bladder cancer.[aafp.org]
  • Diagnostic Workup [1] H&P, including detailed pelvic examination under anesthesia.[oncolink.org]
  • Although the amount of blood in the urine may be different, the types of conditions that can cause the problem are the same, and require the same kind of workup or evaluation.[medicinenet.com]
  • In patients with recurrent or persistent lower urinary tract symptoms, further urologic workup including thorough history taking, physical examination, and imaging surveys is warranted. Fang D, Liu P, Li X, et al.[cancerindex.org]
  • Diagnosis and Staging The most common way in which UTUC is diagnosed is through a workup for hematuria.[hematologyandoncology.net]

Treatment

  • CONCLUSION: Current modalities of treatment are ineffective for local control and survival; new treatment strategies are needed for female urethral cancers.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Current modalities of treatment are ineffective for local control and survival. New treatment strategies are needed for urethral cancer.[ncbi.nlm.nih.gov]
  • Treatment will therefore have to follow rules established for the treatment of similar conditions.[ncbi.nlm.nih.gov]
  • This outpatient treatment is well tolerated, preserves voluntary urinary function and enhances quality of life.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Radiotherapy is an effective treatment for carcinoma of the female urethra and preserves normal anatomy and function.[ncbi.nlm.nih.gov]

Prognosis

  • Despite administration of systemic chemotherapy, the prognosis of the patient has worsened due to the extensive metastatic disease.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: We conclude that the prognosis for patients with urethral carcinoma has improved, and some of the patients are having a prolonged disease-free survival due, in part, to more effective local and regional control and improved chemotherapy.[ncbi.nlm.nih.gov]
  • Neo-adjuvant treatment may be advisable with the aim of improving the poor prognosis, even if the efficacy is not certain while it can delay the radical treatment of the disease.[ncbi.nlm.nih.gov]
  • Advanced disease, at least for the present, tends to carry a grim prognosis.[ncbi.nlm.nih.gov]
  • Clear cell variety of adenocarcinoma is a rarer entity which usually has a better prognosis than other variants. Lymph node metastasis is seen in about 30%of urethral cancers.[cancerjournal.net]

Etiology

  • Various studies shown that infection and chronic irritation as etiologic in the pathogenesis of this malignancy.[mpuh.org]
  • Urethral cancers are rare in both men and women, although they have slightly different epidemiology and etiology depending on sex.[bradyurology.blogspot.com]
  • Etiology of Urethral Carcinoma Risk factors include chronic inflammation or infection, diverticula, caruncle, papillomas, adenomas, leukoplakia and bladder cancer.[urology-textbook.com]
  • The etiology of this disease is unclear although infections, especially with human papilloma virus, and chronic irritations are cited as possible causes. Diagnosis is usually established by cystoscopy and transurethral biopsy.[healio.com]
  • Furthermore, lymphoma is the most common etiology of neoplastic fever of underdetermined origin.[antimicrobe.org]

Epidemiology

  • METHODS: The National Cancer Institute Surveillance, Epidemiology, and End Results database was used to identify persons diagnosed with primary urethral carcinoma from 1973 to 2002.[ncbi.nlm.nih.gov]
  • Survival data are from NCI’s Surveillance, Epidemiology, and End Results (SEER) Program and represent cancer in approximately one-fourth of the U.S. population. The patient and tumor characteristics shown vary by cancer site.[web.archive.org]
  • Epidemiology Urothelial cancer ; is the most common tumor of the urinary tract.[amboss.com]
  • Urethral cancers are rare in both men and women, although they have slightly different epidemiology and etiology depending on sex.[bradyurology.blogspot.com]
  • Epidemiology Seldom, annual incidence of 1.5 per million population. Etiology of Urethral Carcinoma Risk factors include chronic inflammation or infection, diverticula, caruncle, papillomas, adenomas, leukoplakia and bladder cancer.[urology-textbook.com]
Sex distribution
Age distribution

Pathophysiology

  • E PIDEMIOLOGY AND PATHOPHYSIOLOGY Ma lignancy and Fever It is well-known that cancer, diagnosed or undiagnosed, can cause fever.[antimicrobe.org]

Prevention

  • Urethral Cancer Urethral cancer is rare, so doctors are still determining how to prevent it.[beaumont.org]
  • Monitoring your alcohol intake and diet may also be factors that can aid in cancer prevention.[sharecare.com]
  • This new technique of wide local excision and neo urethra allows the patient to void perineally and is continent it also prevents supra major surgery with ileal conduit as described above.[strictureurethra.com]
  • Preventive Services Task Force recommends against routine screening for bladder cancer in adults. A 24 Patients with symptoms of bladder cancer should be evaluated with cystoscopy and bladder wash cytology.[aafp.org]
  • You may get chemotherapy before or after the surgery to prevent the cancer from coming back. Stage 3 Treatment includes partial or total cystectomy, along with chemotherapy. Radiation and immunotherapy may be options, as well.[healthline.com]

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