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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stress urinary incontinence is a distinctly unusual finding in men who have had no prior pelvic or urologic surgery. Seven men with stress urinary incontinence underwent urodynamic evaluation. All patients had urethral smooth muscle dysfunction manifested by decreased urethral pressure and the presence of radiographic contrast material in the proximal urethra. One patient with adenocarcinoma of the prostate had had a prior prostatectomy and subsequently had metastases with cauda equina compression. One patient had destruction of the pelvic plexus from metastastic choriocarcinoma. All other patients had neurologic lesions involving spinal roots L1 and/or L2, resulting in interference with adrenergic innervation of the proximal urethra. Thorough neurologic evaluation should be obtained in a man with stress urinary incontinence who has had no prior operation that could damage the pelvic plexus or urethral sphincter mechanisms.
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PMID:Stress urinary incontinence in men. 715 78

The authors report on the third case in the world of mesonephric adenocarcinoma of the bladder. The tumour which may well derive from embryonic rests of mesonephric origin, developed in the region of the bladder neck and proximal urethra. The symptoms that led to the consultation consisted of dysuria with episodes of complete urinary retention. Clinical examination and IVU confirmed the presence of a tumour which could be seen on endoscopy, thus enabling biopsy. As there were no metastases, irradiation with telecobalt cured this patient. The undesired side-effect was the development of bladder retraction. This necessitated a cutaneous transcolic ureterostomy. The histological structure of these tumours is distinctive and easily recognizable and should not be missed by the pathologist. In regard to this rare tumour, it is interesting to note its radiosensitivity, and hence the potential of radiotherapy to effect a cure in patients so afflicted.
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PMID:[Mesonephric adenocarcinoma of the bladder]. 716 14

Malignant melanoma of the female genital tract comprises 3% of all melanomas afflicting females. Melanoma of the vulva is most common, comprising 45 patients treated by the author. Thirty-two percent had metastases to the regional lymph nodes on presentation. Five-year survival is 31.6%. Radical vulvectomy and radical groin dissection is the treatment of choice. Only 80 melanomas of the vagina have been reported, with cures being an extreme rarity. Forty cases of the female urethra reported in the literature and only five survivors have been reported. Melanoma of the uterus is extremely rare, with no cures recorded. Melanoma of the ovary may occur within a teratoma but most frequently is metastatic.
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PMID:Malignant melanoma of the female genital system: a report of 48 patients and review of the literature. 725 56

We report on 2 men and 2 women with locally advanced squamous cell carcinoma of the urethra who were treated with combination chemotherapy and radiation. Treatment consisted of 1,000 mg./M.2 5-fluorouracil plus 15 mg./M.2 mitomycin-C followed by 30 to 50 Gy. external beam radiation. The 2 women achieved durable complete responses, and are alive with no evidence of disease 94 and 43 months later, respectively. The men also had regional lymph node metastases, and 1 achieved complete response and has no evidence of disease 98 months posttreatment, while the other experienced partial response in the primary tumor and complete response in the involved inguinal nodes. The latter patient died of an unrelated cause with residual disease at 7 months. Only mild toxicity occurred in 3 patients. This regimen of chemotherapy and radiation is well tolerated and should be considered as primary therapy for invasive squamous cell carcinoma of the male and female urethra.
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PMID:Combination radiation and chemotherapy for the treatment of squamous cell carcinoma of the male and female urethra. 775 54

We describe a surgical technique to conserve urinary continence in 7 women who underwent radical cystectomy with construction of an orthotopic ileal neobladder for infiltrating bladder carcinoma. The selection of the patients and the surgical procedure to preserve the anatomical and functional integrity of the female urethra are described. Followup ranged from 7 to 28 months. There were no postoperative deaths or serious clinical complications. The urinary continence rate was 100% during the day and 71% at night with micturition at regular 3-hour intervals. The vesical capacity varied from 250 to 400 cc and pressure at maximum capacity from 10 to 25 cm. water. Urinary flow was satisfactory and the urethral pressure profile showed a normal sphincteric mechanism at rest. Two patients died of metastases at 14 and 8 months postoperatively, and 5 are alive and disease-free. We believe that these results confirm the possibility of obtaining micturition in women via the urethra following radical cystectomy.
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PMID:Orthotopic ileal neobladder in female patients after radical cystectomy: 2-year experience. 785 82

We report the case of a 77-year-old man who presented with a polypoid tumor in the distal urethra. It was excised, and a histological diagnosis of malignant melanoma was made. The patient had no history of previous cutaneous biopsies or suspicious pigmented lesions; therefore, the melanoma was considered to be primary in the urethra. The patient declined therapy and died 28 months later with local tumor progression. The autopsy revealed a widespread metastatic disease. The male urethra is rarely the primary site of a malignant melanoma. This event has so far been described in about 45 patients. The case is discussed in view of the pertinent literature.
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PMID:[Primary malignant melanoma of the male urethra. Case report and discussion of the literature]. 797 59

Using polymerase chain reaction with type-specific human papillomavirus type 16 and 18 primers, and general primers screening for 9 other genotypes, we analyzed archival surgical specimens of urethral carcinoma from 18 women (17 with invasive cancer and 1 with carcinoma in situ). Human papillomavirus was detected in invasive urethral carcinoma specimens from 10 of 17 women (59%) and in the patient with carcinoma in situ. Human papillomavirus type 16 was found in 8 patients with invasive carcinoma (47%) and 1 with carcinoma in situ, and general primer polymerase chain reaction demonstrated human papillomavirus that could not be typed in 2 patients (12%). Type 16 was detected in metastases from 4 patients; complete concordance for the presence of human papillomavirus in primary and metastatic disease was noted. Eight of 10 women with squamous cell carcinoma and both with transitional cell carcinoma harbored human papillomavirus; 5 women with undifferentiated carcinoma or adenocarcinoma were all negative for human papillomavirus. Concurrently excised cervical tissue was available from 5 patients; 1 had cervical carcinoma in situ positive for human papillomavirus of the same type as the urethral carcinoma. These findings strongly suggest that human papillomavirus, particularly type 16, is associated with a substantial number of carcinomas of the female urethra but a stratification of specific histotypes associated with human papillomavirus may exist.
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PMID:A high association of oncogenic human papillomaviruses with carcinomas of the female urethra: polymerase chain reaction-based analysis of multiple histological types. 825 31

Neonatal estrogenization of the mouse with diethylstilbestrol (DES; 2 micrograms./pup/day for days 1 to 3) or 17 beta-estradiol (200 micrograms./pup/day for days 1 to 3) resulted in epithelial dysplasia in the posterior periurethral region of the prostate at the age of 1 year. The dysplastic lesions ranged from mild to severe and, in addition to emergence of nuclear anaplasia, the architectural pattern of the glands was disturbed. Prenatal estrogenization (100 micrograms./kg. of maternal body weight on days 13 and 15 of gestation) only resulted in mild epithelial hyperplasia and occasional dysplasia in the ventral lobe of the prostate, but not in the posterior periurethral region. When neonatally estrogenized mice were allowed to grow until the age of 18 months, the degree and extent of the dysplasia of the posterior periurethral region was increased, but no frank invasion or metastases could be demonstrated. Combined estrogen and androgen treatment of neonatally estrogenized mice for 3 months (between 9 and 12 months of age) augmented nuclear dysplasia, but no invasive growth was seen in this group, either. Mild epithelial dysplasia was found in the dorsolateral lobes and coagulating glands of similarly treated control animals. A relation between the activation of certain proto-oncogenes and the development of several cancers has been shown in humans and experimental animals. In the present study, Northern blot analysis of total RNAs showed that the levels of c-myc mRNA were increased in the ventral and dorsolateral lobes, coagulating glands and prostatic urethra of neoDES mice at the age of 9 months. However, it remains to be determined whether the increase in c-myc expression is involved in the development of hyperplastic and dysplastic changes in the prostate of neoDES mice.
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PMID:Prostatic dysplasia associated with increased expression of c-myc in neonatally estrogenized mice. 850 17

Pelvic exenteration has usually been employed as salvage treatment for gynecologic malignancies which have failed primary radiotherapy. The therapeutic mainstay for vulvar melanomas has become wide local excision with or without concurrent regional node dissection. Patients with primary melanoma of the vagina who undergo exenteration as primary therapy may experience 50% 5-year survival if the pelvic nodes are free of metastases. However, the overall 5-year survival for vaginal melanoma is 15%. In our patient population, there have been four patients with vaginal or urethral melanomas treated primarily with pelvic exenteration. The purpose of this study was to report that patients with vaginal or urethral melanomas over 3 mm in thickness may benefit from primary pelvic exenteration. Four patients underwent pelvic exenteration at Indiana University Medical Center for malignant melanoma of the vagina or urethra between 1986 and 1992. The pathologic specimens of all patients were analyzed for thickness, growth pattern, and nodal metastases. Patient age ranged from 50 to 71. Thickness of the melanomas ranged from > 3 to 12 mm. All four patients underwent exenterations, three total and one anterior. All patients had negative pelvic and inguinal nodes at the time of surgery. None of the patients has experienced a recurrence. Three of four patients are alive without evidence of disease at 31 to 97 months following their exenteration. One patient died postoperatively of cardiopulmonary complications. Patients with melanomas of the vagina and female urethra, greater than 3 mm in thickness, may benefit from primary pelvic exenteration.
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PMID:Pelvic exenteration for malignant melanomas of the vagina or urethra with over 3 mm of invasion. 852 51

Biopsy and necropsy specimens, comprising 107 primary carcinomas and three mesenchymal tumours, were reviewed from 110 dogs with cancer of the bladder, urethra, or both. Histological classifications developed for the assessment of human bladder cancer were found to be readily applicable to the dog. These classifications are based on histological features, including the pattern of growth, the cell type, the grade of transitional tumour and the depth of invasion of the bladder wall. Features associated with localized disease in canine transitional cell carcinoma included papillary architecture, "in-situ" tumour, low tumour grade and a strong peritumoral lymphoid cell reaction. Features of tumours with metastasis included infiltrating and non-papillary architecture, increasing tumour grade, depth of invasion, vascular invasion and presence of peritumoral fibrosing reaction. Wide variability was found within single tissue samples, indicating that multiple sample sites are necessary for the adequate characterization of a given lesion. Statistically significant correlations were found between: tumour grade and depth of invasion (P < 0.0001); tumour grade and presence of metastases (P < 0.029); and peritumoral desmoplasia and metastases (P < 0.029). It was concluded that canine bladder cancer could be classified for the purpose of clinical management with a modified World Health Organization system as developed for human tumours.
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PMID:Pathology of canine bladder and urethral cancer and correlation with tumour progression and survival. 854 69


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