原發性女性尿道旁腺癌:病例報告及文獻回顧

于宗玉¹、楊文洲¹、宋明澤²

¹高雄長庚紀念醫院泌尿科，²病理科

Primary female periurethral adenocarcinoma: a case report and review of the literature

Tsung-Yu Yu¹, Wen-Chou Yang¹, Min Tse Sung²

¹Kaohsiung Chang Gung Memorial Hospital, Department of Urology and² Pathology

Abstract:

Primary female urethral cancer is a rare disease, which is reported in <0.003% of all urogenital tract malignancies in women. Adenocarcinoma of the female urethra is extremely rare, accounting for 10% of the primary female urethral cancers. The most common histologic subtypes are columnar cell/mucinous adenocarcinoma and clear cell adenocarcinoma. One origin of primary urethral adenocarcinoma is thought to be the periurethral Skene glands and the others develop from malignant transformation of intestinal metaplasia or divergent differentiation of urothelial neoplasm. We report the case of a 67-year-old lady who presented with acute urine retention and periurethral mass. Transvaginal biopsy showed adenocarcinoma and she underwent anterior exenteration and ileal conduit urinary diversion. Direct tumor invasion to both bladder and anterior vaginal wall and metastasis to right iliac lymph node, pT4N1M0 stage IV, were identified by pathological evaluation. Immunohistochemically, the tumor cells were positive for CK7, beta-catenin, and focal positive for CDX2, and negative for CK20, PAX8, NKX3-1 and prostate specific antigen (PSA). We reviewed the present literatures, combination of surgery followed by chemotherapy and radiotherapy is the most suitable treatment for locally advanced urethral adenocarcinoma.