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Urethral carcinoma in situ: recognition and management

  • Urology - Original Paper
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Abstract

Purpose

Urethral carcinoma in situ (CIS) is an uncommon malignancy that is poorly described in the published literature and is often under-recognized in the clinical setting. This short case series reports some challenges associated with the recognition and management of this disease.

Methods

A retrospective chart review was done over a 12-year period of patients presenting with urethral cancer to the Johns Hopkins Hospital. Four patients were identified with CIS of the anterior urethra, and their demographic and clinical data were recorded.

Results

Three patients presented with meatal lesions that were initially treated as infectious/inflammatory diseases before diagnoses of malignancy were determined following lesion biopsy. 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. Concurrent lymph node dissections were undertaken in two patients who had clinical or radiologic evidence of lymphadenopathy. One patient had persistent disease even after aggressive urethral resection, and he succumbed to his illness 2 years later.

Conclusion

This is the largest series of urethral CIS, a disease with potentially serious consequences. A high index of suspicion should be maintained when evaluating and managing these patients.

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References

  1. Swartz MA, Porter MP, Lin DW, Weiss NS (2006) Incidence of primary urethral carcinoma in the United States. Urology 68(6):1164–1168

    Article  PubMed  Google Scholar 

  2. Dayyani F, Hoffman K, Eiffel P, Guo C, Vikram R, Pagliaro LC et al (2014) Management of advanced primary urethral carcinomas. BJU Int 114(1):25–31

    Article  PubMed  Google Scholar 

  3. Kim SJ, Maclennan GT (2005) Tumors of the male urethra. J Urol 174(1):312

    Article  PubMed  Google Scholar 

  4. Gakis G, Witjes JA, Comperat E, Cowan NC, DeSantis M, Lebret T et al (2013) EAU Guidelines on primary urethral carcinoma. Eur Urol 64(5):823–830

    Article  PubMed  Google Scholar 

  5. Velazquez EF, Soskin A, Bock A, Codas R, Cai G, Baretto JE et al (2005) Epithelial abnormalities and precancerous lesions of the anterior urethra in patients with penile carcinoma: a report of 89 cases. Mod Pathol 18(7):917–923

    Article  PubMed  Google Scholar 

  6. Chaux A, Han JS, Lee S, Gonzalez-Roibon N, Sharma R, Burnett AL et al (2013) Immunohistochemical profile of the penile urethra and differential expression of GATA3 in urothelial versus squamous cell carcinomas of the penile urethra. Hum Pathol 44(12):2760–2767

    Article  CAS  PubMed  Google Scholar 

  7. Althahausen AF, Prout GRJ, Daly JJ (1976) Non-invasive papillary carcinoma of the bladder associated with carcinoma in situ. J Urol 116(5):575–580

    Google Scholar 

  8. Chade DC, Shariat SF, Godoy G, Savage CJ, Cronin AM, Bochner BH et al (2010) Clinical outcomes of primary bladder carcinoma in situ in a contemporary series. J Urol 184(1):74–80

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sylvester RJ, van der Meijden A, Witjes JA, Jakse G, Nonomura N, Cheng C et al (2005) High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology 66(6):90–107

    Article  PubMed  Google Scholar 

  10. Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BWG, Comperat E et al (2013) EAU Guidelines on non-muscle invasive urothelial carcinoma of the bladder: update 13. Eur Urol 64(4):639–653

    Article  PubMed  Google Scholar 

  11. Pedrosa JA, Amstutz SP, Bihrle R, Mellon MJ (2014) Distal urethrectomy for localized penile squamous carcinoma in situ extending into the urethra: an updated series. Int Urol Nephrol 46(8):1551–1555

    Article  CAS  PubMed  Google Scholar 

  12. Smith Y, Hadway P, Ahmed S, Perry MJ, Corbishley CM, Watkin NA (2007) Penile-preserving surgery for male distal urethral carcinoma. BJU Int 100(1):82–87

    Article  PubMed  Google Scholar 

  13. Burnett AL (2016) Penile preserving and reconstructive surgery in the management of penile cancer. Nat Rev Urol 13(5):249–257

    Article  PubMed  Google Scholar 

  14. Dalbagni G, Zhang ZF, Lacombe L, Herr HW (1999) Male urethral carcinoma: analysis of treatment outcome. Urology 53(6):1126–1132

    Article  CAS  PubMed  Google Scholar 

  15. Weiner JS, Liu ET, Walther PJ (1992) Oncogenic human papillomavirus type-16 is associated with squamous cell cancer of the male urethra. Cancer Res 52:5018–5023

    Google Scholar 

  16. Cupp MR, Malek RS, Goellner JR, Espy MJ, Smith TF (1996) Detection of human papillomavirus DNA in primary squamous cell carcinoma of the male urethra. Urology 48(4):551–555

    Article  CAS  PubMed  Google Scholar 

  17. Dinney CPN, Johnson DE, Swanson DA, Babaian RJ, Von Eschenbach AC (1994) Therapy and prognosis for male anterior urethral carcinoma: an update. Urology 43(4):506–514

    Article  CAS  PubMed  Google Scholar 

  18. Hopkins SC, Nag SK, Soloway MS (1984) Primary carcinoma of the male urethra. Urology 23(2):128–133

    Article  CAS  PubMed  Google Scholar 

  19. Karnes RJ, Breau RH, Lightner DJ (2010) Surgery for urethral cancer. Urol Clin North Am 37(3):445–457

    Article  PubMed  Google Scholar 

  20. Eng TY, Naguib M, Galang T, Fuller CD (2003) Retrospective study of the treatment of urethral cancer. Am J Clin Oncol 26(6):558–562

    Article  PubMed  Google Scholar 

  21. Gheiler EL, Tefilli MV, Tiguert R, De Oliveira JG, Pontes JE, Wood DP (1998) Management of primary urethral cancer. Urology 52(3):487–493

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Arthur L. Burnett.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Berjeaut, R.H., Persaud, M.D.I., Sopko, N. et al. Urethral carcinoma in situ: recognition and management. Int Urol Nephrol 49, 637–641 (2017). https://doi.org/10.1007/s11255-017-1512-3

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  • DOI: https://doi.org/10.1007/s11255-017-1512-3

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