Presentation
Methods: A retrospective chart review was done over a 12-year period of patients presenting with urethral cancer to the Johns Hopkins Hospital. [jhu.pure.elsevier.com]
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]
Entire Body System
- 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]
chest pain, pleural effusion Bone: pain in long bones / vertebrae, pathological fractures Carcinoma of the renal pelvis Ureteral carcinoma Painless gross hematuria throughout micturition Flank pain Urethral carcinoma Painless gross hematuria at the [amboss.com]
Eyes
- Hemianopsia
The patient had no other neurological deficits except for left homonymous hemianopsia. [surgicalneurologyint.com]
Neurologic
- Homonymous Hemianopsia
The patient had no other neurological deficits except for left homonymous hemianopsia. [surgicalneurologyint.com]
Urogenital
- 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. [jhu.pure.elsevier.com]
Patients often present with painless gross hematuria or irritative voiding symptoms, although some cases are incidentally detected ( microscopic hematuria on urinalysis ). [amboss.com]
Most men present with symptoms of urethral stricture; only a few present with hematuria or a bloody discharge. Sometimes if the tumor is advanced, a mass is felt. [msdmanuals.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]
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]
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]
- Urethral Bleeding
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]
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]
Surgical Management In the female, most tumors present with bleeding or distal urethral mass. Distal urethral or anterior lesions usually present early and are diagnosed while at low stage. [health.am]
- Urethral Discharge
[…] in the perineum, labia, or penis Itching Incontinence Pain during or after sexual intercourse (dyspareunia) Painful urination (dysuria) Recurrent urinary tract infection (UTI) Urethral discharge and swelling Advanced cases of urethral cancer may produce [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]
[…] carcinoma Painless gross hematuria at the beginning of micturition Bladder outlet obstruction Irritative voiding symptoms (common, esp. in women) Palpable inguinal lymphadenopathy Urethral discharge A mass may be palpable along the urethra (bimanual [amboss.com]
- Nocturia
As the disease progresses, symptoms include the following: Blood in the urine (hematuria) Diminished urine stream and straining to void (caused by urethral stricture) Frequent urination and increased nighttime urination (nocturia) Hardening of tissue [healthcommunities.com]
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
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]
Prognosis
Despite administration of systemic chemotherapy, the prognosis of the patient has worsened due to the extensive metastatic disease. [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]
Cystoscopy and biopsy : direct visualization of urethral and bladder mucosa with possible simultaneous biopsies or therapeutic resections Ultrasound (kidney, ureter, bladder ) : if CT is contraindicated (e.g., pregnant women), or if etiology of hematuria [amboss.com]
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]
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]
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 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]
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]
[…] acidosis Formation of urinary stones Secondary malignant diseases Complications associated with the required intestinal resections ( malabsorption, diarrhea ) Carcinoma of the renal pelvis and ureters References: [3] [12] [19] [20] [21] [22] [23] Prognosis Prevention [amboss.com]