[Diagnosis and treatment of tumors of urinary tract].
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This is a report on the treatment of urethral neoplasms in a series of 331 with ages ranging from 21 to 88 years. The most common symptoms of manifestation of the lesion include: bleeding, burning and stinging during urination, eventually pain associated with movements. In forty-one patients the polyps are removed operatively through excision, in 185-through electrocoagulation, and in eighteen-excision with ensuing electrocoagulation Eighty-seven patient are subjected to conservative treatment because of the presence of urethral mucosa prolapse. The histological findings show evidence of polyps of the urethra in 206 cases, and urethral caruncle in thirty-six. The obtained results are estimated as good. Mass screening examinations of women are recommended.
PURPOSE: A case of a urethral recurrence found 15 years after radical cystectomy is reported. METHODS/RESULTS: A 78-year-old man, who had undergone radical cystectomy at age 63, presented with urethral bleeding and positive cytology in urethral washing. The urethra was surgically resected. Pathologic examination revealed transitional cell carcinoma located in the distal and mid portion of the penile urethra. CONCLUSION: Evidence suggested that urethral recurrence resulted from the implantation from the primary bladder tumor; in addition, the urethral neoplasm had scarcely grown in the penile urethra for 15 years.
Three female patients (mean age 55) with carcinoma of the urethra were treated with combined external beam irradiation (4,000 to 5,000 rads) and interstitial irradiation with iridium Ir 192 (2,700 to 3,000 rads) applied with a modified Syed-Neblett template. Two patients are alive with no evidence of disease at 27 and 37 months. One patient died of a second primary tumor at 30 months, without histologic evidence of the original urethral neoplasm. No patient had significant complications of therapy. This treatment regimen is effective for selected women with urethral carcinoma.
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Primary malignant urethral neoplasms are unusual in women. Those of mixed histologic type are so rare as to define adequate documentation. We report the case of an elderly black woman with an urethral carcinoma which had features of a transitional cell carcinoma as well as clear cell adenocarcinoma. The histologic and ultrastructural features are presented and the histogenesis is discussed. Although the patient had both high grade and high stage disease and failed initially after external beam radiation therapy, she is alive and well, without evidence of recurrent disease, 19 months after anterior exenteration.
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