Urethral cancer pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 32: Line 32:


[[Fragile histidine triad]] ([[FHIT]]) gene may play a role in causing [[Bladder|bladde]]<nowiki/>r urothelial carcinoma <ref name="pmid22613411">{{cite journal |vauthors=Zhang CT, Lu R, Lin YL, Liu RL, Zhang ZH, Yang K, Dang RF, Zhang HT, Shen YG, Kong PZ, Ren HL, Li XL, Quan W, Xu Y |title=The significance of fragile histidine triad protein as a molecular prognostic marker of bladder urothelial carcinoma |journal=J. Int. Med. Res. |volume=40 |issue=2 |pages=507–16 |date=2012 |pmid=22613411 |doi=10.1177/147323001204000212 |url=}}</ref>. 
[[Fragile histidine triad]] ([[FHIT]]) gene may play a role in causing [[Bladder|bladde]]<nowiki/>r urothelial carcinoma <ref name="pmid22613411">{{cite journal |vauthors=Zhang CT, Lu R, Lin YL, Liu RL, Zhang ZH, Yang K, Dang RF, Zhang HT, Shen YG, Kong PZ, Ren HL, Li XL, Quan W, Xu Y |title=The significance of fragile histidine triad protein as a molecular prognostic marker of bladder urothelial carcinoma |journal=J. Int. Med. Res. |volume=40 |issue=2 |pages=507–16 |date=2012 |pmid=22613411 |doi=10.1177/147323001204000212 |url=}}</ref>. 
== Associated Conditions ==
* Urethral cancers in proximal urethra have worse prognosis than those arising in the distal portion in men/


== Gross Pathology ==
== Gross Pathology ==

Revision as of 19:44, 12 January 2019

Urethral cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Urethral cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT Scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Urethral cancer pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Urethral cancer pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Urethral cancer pathophysiology

CDC on Urethral cancer pathophysiology

Urethral cancer pathophysiology in the news

Blogs on Urethral cancer pathophysiology

Directions to Hospitals Treating Urethral cancer

Risk calculators and risk factors for Urethral cancer pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2], Aida Javanbakht, M.D.

Overview

Urethral cancer is a rare disease. The pathophysiology of urethral cancer depends on the histological subtypes. It could be primary from epithelial origin or secondary like from bladder cancer which is more common than primary type.

Pathogenesis

Mucous cells in the urethra have the ability to turnover rapidly. In primary type of the urethral cancer It has been suggested that defect in DNA repair mechanism may cause urethral cancer. Other etiologies for primary types are:

Chronic inflammation and strictures: May happen after any surgery on urethra like urethroplasty [1].

Although cigarette smoking can cause bladder cancer but the role of it in causing primary urethral cancer is still unknown.

Also the pathogenesis is different in male and female.

In male prostatic and membranous portions of the urethra cancer are more from bladder cancer. Bulbous and membranous portions urethral cancers are most commonly squamous cell carcinoma.

In female proximal 2/3 of the urethral cancer are more primary types and distal 1/3 is usually squamous cell carcinoma.

Genetics

The exact gene and mutations that cause urethral cancer are unlnown.

Mutation in TERT promoter, PAX8, GATA3, P63, P40, p53 may play role in sarcomatoid urothelial carcinoma [5].

Fragile histidine triad (FHIT) gene may play a role in causing bladder urothelial carcinoma [6]

Associated Conditions

  • Urethral cancers in proximal urethra have worse prognosis than those arising in the distal portion in men/

Gross Pathology

In end stage type they may appear as an exophytic mass.

Microscopic Pathology

The microscopic view of urethral cancer is depended on the location of teh cancer. The type of the cancer in the distal part of the urethra is usually squamous cell. [7]

    • SCC: high mitotic activity, nuclear atypia. Positive with cytoplasmic beta-catenin stain. pleomorphic tumor cells with focal or abundant keratinization, intercellular bridges. Stains: High molecular weight cytokeratin (CK903, CK5/6), p63, p16.
    • Adenocarcinoma:  simple or pseudostratified columnar epithelium with hyperchromatic nuclei. vacuolated cytoplasm with mucin pools. Stains: P53, CK20.
    • Clear Cell: clear or eosinophilic cytoplasm, vacuoles in the cytoplasm, hyperchromatic nuclei. Positive with  p53 and vimentin stain. Hobnail changes and extracellular mucoid material.

References

  1. Colapinto V, Evans DH (October 1977). "Primary carcinoma of the male urethra developing after urethroplasty for stricture". J. Urol. 118 (4): 581–4. PMID 916053.
  2. Cupp MR, Malek RS, Goellner JR, Espy MJ, Smith TF (October 1996). "Detection of human papillomavirus DNA in primary squamous cell carcinoma of the male urethra". Urology. 48 (4): 551–5. doi:10.1016/S0090-4295(96)00246-4. PMID 8886059.
  3. Mohan H, Bal A, Punia RP, Bawa AS (February 2003). "Squamous cell carcinoma of the prostate". Int. J. Urol. 10 (2): 114–6. PMID 12588611.
  4. Ahmed K, Dasgupta R, Vats A, Nagpal K, Ashrafian H, Kaj B, Athanasiou T, Dasgupta P, Khan MS (June 2010). "Urethral diverticular carcinoma: an overview of current trends in diagnosis and management". Int Urol Nephrol. 42 (2): 331–41. doi:10.1007/s11255-009-9618-x. PMID 19649767.
  5. Wang X, Lopez-Beltran A, Osunkoya AO, Wang M, Zhang S, Davidson DD, Emerson RE, Williamson SR, Tan PH, Kaimakliotis HZ, Baldridge LA, MacLennan GT, Montironi R, Cheng L (April 2017). "TERT promoter mutation status in sarcomatoid urothelial carcinomas of the upper urinary tract". Future Oncol. 13 (8): 705–714. doi:10.2217/fon-2016-0414. PMID 28052688.
  6. Zhang CT, Lu R, Lin YL, Liu RL, Zhang ZH, Yang K, Dang RF, Zhang HT, Shen YG, Kong PZ, Ren HL, Li XL, Quan W, Xu Y (2012). "The significance of fragile histidine triad protein as a molecular prognostic marker of bladder urothelial carcinoma". J. Int. Med. Res. 40 (2): 507–16. doi:10.1177/147323001204000212. PMID 22613411.
  7. Grivas PD, Davenport M, Montie JE, Kunju LP, Feng F, Weizer AZ (December 2012). "Urethral cancer". Hematol. Oncol. Clin. North Am. 26 (6): 1291–314. doi:10.1016/j.hoc.2012.08.006. PMID 23116581.
  8. Cantiello F, Cicione A, Salonia A, Autorino R, Tucci L, Madeo I, Damiano R (May 2013). "Periurethral fibrosis secondary to prostatic inflammation causing lower urinary tract symptoms: a prospective cohort study". Urology. 81 (5): 1018–23. doi:10.1016/j.urology.2013.01.053. PMID 23608423.