Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a case of primary clear cell cancer of the urethra in a woman presenting with acute urinary retention. The diagnosis was based on cystoscopy and confirmed by histological examination of urethral biopsies. Treatment consisted of urethrocystectomy with creation of an "Indiana pouch". The pathological stage was T3N2M0 [1]. Three months postoperatively, the patient presented with inguinal lymph node metastases. She was treated with 3 courses of chemotherapy (mitomycin and 5-fluorouracil) combined with radiotherapy. With a follow-up of 10 months, the patient is still alive and inguinal lymph nodes have regressed. This case report emphasizes the rarity of this histological type and describes the management of urinary retention in a woman when an underlying specific disease is suspected.
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PMID:[Acute urinary retention secondary to clear cell adenocarcinoma of the urethra]. 1129 50

Ejaculation is mediated by sympathetic fibers originating from the D10-L2 medullar center. These nerves rise from the lumbar ganglia of the paravertebral sympathetic trunk and travel posteriorly to the vena cava and then to the interaortocaval space, on the right side, and laterally to the aorta, on the left side. They are the principal constituents of the superior hypogastric plexus. Many surgical operations can cause an ejaculation disorder, but the most important is retroperitoneal lymphadenectomy (RL) for testis cancer, because it involves young patients and it has been the subject of important researches in order to perform lymph node dissection without ejaculation loss (unilateral lymphadenectomy and nerve sparing lymphadenectomy). Our experience concerns 41 patients who underwent RL for testis cancer from 1983 to 1998. Survival rate was 95.2% (mean follow up 64 months). RL was performed bilaterally in 14 patients. Two of them died of metastases within 2 years after the operation. Ejaculation was maintained in only 4 of the 12 surviving patients (33%). All the 17 patients (100%) underwent right monolateral RL and 7 of the 10 (70%) underwent left monolateral RL preserved ejaculation. The anatomosurgical concepts of the RL sparing the ejaculation can be adopted in other retroperitoneal surgical operations that can produce ejaculation disorders, such as wide lymphadenectomy for renal cell carcinoma or tumors of the upper urinary tract, exeresis of pre- aortic tumors, exeresis or disjunction of horseshoe kidney and aorto-iliac revascularization. Surgical therapy of benign prostatic hyperplasia (BPH) (open surgery or transurethral prostatic resection) is associated with retrograde ejaculation in nearly 100% of cases. The mechanism of the dysfunction is clear, if following the procedure the bladder neck remains opened. Loss of ejaculation is reported in variable percentage after the newer endoscopic techniques for the treatment of BPH. Transurethral needle ablation (TUNA) seems to have the lower risk of retrograde ejaculation. Retrograde ejaculation can also be related to a traumatic injury of the posterior urethra, because of the trauma itself or the therapy. Finally, the ejaculation disorder can be produced by several drugs that block, as a main or secondary effect, the alpha-adrenoreceptors or act at the central level. This side effect has to be kept in mind when these drugs are used in young or sexually active patients.
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PMID:Iatrogenic ejaculation disorders and their prevention. 1134 16

A clear cell adenocarcinoma of the urethra associated with so-called nephrogenic metaplasia occurring in a 57-year-old male patient is presented. Ten months following total urethrectomy, multiple pulmonary metastases had developed. The patient died 2.5 years after surgery. The possible histogenesis of clear cell adenocarcinoma of the lower urinary tract - reported to develop in the male urethra only in a very few cases - is reviewed briefly. We favor an origin from preexisting nephrogenic metaplasia as one of the possible histogenetic pathways.
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PMID:Clear cell adenocarcinoma of the male urethra in association with so-called nephrogenic metaplasia. 1146 32

Villous adenomas arising in the urinary tract are rare. We identified 18 cases of villous adenomas of the bladder, urachus, and prostatic urethra. Patients ranged in age from 53 to 93 years with an average age of 69.6 years and a male preponderance of 67%. In six cases (33%), the lesion was pure villous adenoma. In three cases (17%), there was villous adenoma with in situ adenocarcinoma. In six cases (33%) there was villous adenoma with in situ and infiltrating adenocarcinoma. One case (6%) had villous adenomas with in situ (noninvasive) papillary urothelial carcinoma. One case (6%) had villous adenomas with in situ adenocarcinoma and in situ papillary (noninvasive) and infiltrating urothelial carcinoma. The remaining case (6%) had villous adenoma with in situ and infiltrating adenocarcinoma and in situ (noninvasive) papillary and infiltrating urothelial carcinoma. Clinical outcome was available in eight of the cases, with a mean follow-up of 4.6 years. No evidence of recurrence was found in two patients with pure villous adenoma or in two patients with villous adenoma and only in situ adenocarcinoma, all of whom were treated by nonradical excision. However, two of three cases with infiltrating cancer developed distant metastases despite radical surgery; the remaining patient was disease-free 11 years after transurethral resection. The case with villous adenoma and in situ urothelial carcinoma progressed to sarcomatoid urothelial carcinoma following partial cystectomy. Eight of 10 villous adenomas cases studied expressed the epitope for mAbDas1, found on colonic epithelium and primary adenocarcinomas of the bladder and urachus but not on normal or neoplastic urothelium. This study expands the spectrum of histologic features accompanying villous adenomas of the urinary tract. Coexisting infiltrating adenocarcinoma is often present, necessitating thorough sampling of any lesion diagnosed by biopsy as villous adenoma. Pure villous adenoma and those well-sampled lesions also containing in situ adenocarcinoma portend a favorable prognosis, even without radical treatment. Coexisting in situ or infiltrating carcinoma suggests a more aggressive course. Histologically, immunohistochemically, and prognostically, these lesions appear analogous to their counterparts in the intestine.
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PMID:Villous adenoma of the urinary tract: a lesion frequently associated with malignancy. 1245 23

Laser treatment is considered to be effective in treating carcinoma in situ of the penis. We, however, report a case with carcinoma in situ of the penis which developed invasive carcinoma and inguinal lymphnode metastases only 6 months after the laser treatment. A 74-year-old man with pseudophimosis presented with redness of the glans penis. A physical examination revealed thick erythema, 12 millimeters in diameter, around the external urethral meatus. Histologically, biopsy revealed squamous cell carcinoma in situ. No metastasis was suspected by physical examination and imaging studies. Although the lesion appeared to slightly extend into the urethra, it was primarily treated with the CO2 laser. Six months after the treatment, however, local recurrence was confirmed by the touch smear cytology, resulting in the partial amputation of the penis. The histopathological examination revealed subepithelial and marked lymphatic invasion of the tumor and positive margin in the urethral stump (squamous cell carcinoma in situ). Further, since bilateral superficial inguinal lymphnode swelling appeared, total amputation of the penis with perineal urethrotomy and pelvic/inguinal lymphnode dissection was performed subsequently. The metastases to bilateral inguinal lymphnodes were confirmed histologically. The patient received adjuvant chemotherapy and has been alive and well without evidence of disease 40 months after the initial treatment.
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PMID:[Carcinoma in situ of the penis rapidly progressing after carbon dioxide laser treatment]. 1196 5

A very rare case of primary adenocarcinoma arising from a paraurethral cyst in a 63-year-old woman is reported. Initially she was diagnosed as having a simple paraurethral cyst because of absent communication with the urethra. The resected paraurethral cyst was histologically associated with adenocarcinoma. We also performed chemotherapy composed of methotrexate, vinblastine, Adriamycin and cisplatin because of lymph node metastasis. Our treatment, however, was not effective and the patient died of systemic metastases.
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PMID:Primary adenocarcinoma arising from a paraurethral cyst in a female patient. 1237 97

Fosfestrol tetrasodium (Honvan) is a synthetic oestrogen-based compound. Studies have suggested its use in the treatment of localised, advanced and hormone-refractory prostate cancer. This series of 17 patients with advanced disease documents the response, both subjective and objective, to standard dose intravenous Honvan infusion. Infusions were well tolerated, with no cardiovascular side-effects. Twelve patients received Honvan as de novo therapy, of whom 10 (83%) described subjective improvement and 11 (92%) had objective evidence of improvement, 11 (92%) had documented falls in prostate-specific antigen (PSA) levels. Nine patients received Honvan infusions as secondary treatment for hormone-escaped disease (1 patient received Honvan for a second time and another for a second and third time). Of these, 1 (11%) had a documented fall in PSA; 3 (33%) reported a subjective symptomatic improvement, and 2 (22%) demonstrated objective evidence of improvement. Patients with symptoms from bulk abdomino-pelvic disease seemed to fare better than those with bony metastases. This may suggest a specific indication for Honvan in a subgroup of patients with acute obstructive events of the ureters, urethra or circulatory vessles, in particular its value as a de novo therapy. In those patients who received Honvan as secondary therapy, some response was seen in a third, but overall these patients remained hormone-refractory.
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PMID:Use of intravenous fosfestrol tetrasodium (Honvan) infusion in treatment of symptomatic advanced prostate cancer. 1249 96

Bladder neoplasia in humans consists of 2 diseases, a low-grade papillary tumor that does not invade or metastasize, and a high-grade lesion that usually invades and metastasizes. Bladder carcinogenesis in rats is most like the low-grade, papillary tumor, although it eventually does progress and invade. In the mouse, models are available that mimic each of these disease processes. Preneoplastic lesions in humans and rodents include various types of hyperplasia, proliferative cystitis, and dysplasia. These preneoplastic and neoplastic lesions arise throughout the urothelium, from the renal pelvis to the urethra, although most commonly in the bladder. Rarely, benign and malignant mesenchymal lesions occur in rats and mice, with a unique submucosal mesenchymal lesion present in some strains of mice. In addition, eosinophilic and clear inclusions in the superficial layer of urothelium in mice, which do not appear to be associated with toxicity or carcinogenesis, have been reported. An approach to evaluation of carcinogenic mechanisms involved in the urothelium is presented. It focuses on distinguishing between DNA reactive carcinogens vs those that act by increasing cell proliferation. Although rodent models do not precisely mimic the human disease, they have provided useful models for furthering our understanding of the carcinogenic process in the urothelium as it pertains to human diseases.
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PMID:Comparative pathology of proliferative lesions of the urinary bladder. 1251 66

Penile metastases from prostate carcinoma are uncommon events, much more in urethra and corpus spongiosum, we add a case to the preexisting literature. A patient with hormone resistant prostate cancer consults for haematuria and voiding difficulties. During TURP we observe tumors at the penile urethra which are resected and result to be prostate cancer metastases. Patient is fine and without voiding disturbance after 7 months of following. We think is an interesant case because there is few reports in literature.
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PMID:[Metastasis of prostatic carcinoma to the urethra: report of a case]. 1462 86

Clear cell adenocarcinoma of the female urethra is extremely rare. We herein describe the 33rd case of clear cell adenocarcinoma of the female urethra in Japan. A 54-year-old female who presented with pollakisuria was referred to our department. Transvaginal examination showed a walnut-sized firm mass on the anterior vaginal wall. Computed tomography, magnetic resonance imaging (MRI), cystourethroscopy and the histopathological findings of the biopsied specimen revealed adenocarcinoma of the urethra. Anterior pelvic exenteration and ileal conduit urinary diversion were performed and the final pathological diagnosis was clear cell adenocarcinoma of the urethra, pT3, pN2. No further adjuvant therapy was conducted. She remains alive 6 months after surgery in spite of paraaortic and inguinal lymph node metastases.
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PMID:[A case of clear cell adenocarcinoma of the female urethra]. 1465 11


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