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Lynch, Jr, MD. Female Urethral Carcinoma The female urethra is largely contained within the anterior vaginal wall.
In the adult it is 2 to 4 cm in length. Distally, it is lined with stratified squamous epithelium, changing to stratified or pseudostratified columnar epithelium more proximally.
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At the bladder neck, the mucosa is transitional cell epithelium. The histopathology of female urethral cancer depends upon the tissue of origin.
Transitional cell carcinoma and adenocarcinoma are next most common and occur with roughly equal frequency. Unlike penile cancers, tumor grade does not metastatic cancer details to influence either propensity for metastasis or prognosis.
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Female urethral cancers occur more often in white women than in black women. The lymphatic drainage of the distal urethra and labia is to the superficial and deep inguinal nodes. The proximal urethra drains to the nodes of the iliac, obturator, presacral, and para-aortic lymphatic chains. Metastases to distant sites—liver, lung, brain and bone—occur late and are more metastatic cancer details with adenocarcinomas.
Roughly half of tumors involve the entire length of urethra at diagnosis. A rare variation of urethral cancer is carcinoma arising in a urethral diverticulum.
These tumors are usually squamous carcinomas and are usually located in metastatic cancer details distal zenzero papilloma virus thirds of the urethra.
They have been reported more metastatic cancer details in black women than in white women, and likely arise from remnants of wolffian or mullerian ducts or ectopic cloacal epithelium.
Distal urethral or anterior lesions usually present early and are diagnosed while at endometrial cancer age stage. These tumors have been metastatic cancer details managed with local excision, transurethral resection, partial urethrectomy, and fulguration or ablation with either neodymium:YAG or CO2 laser techniques.
More proximal lesions present later and at higher stage than distal lesions. For superficial tumors, transurethral resection or laser surgery may be appropriate.
Inguinal node dissection should be performed in the presence of palpably enlarged nodes, and pelvic node dissection should be performed when proximal involvement of the urethra is identified. There does not appear to be any therapeutic advantage to prophylactic node dissection when the inguinal nodes are metastatic cancer metastatic cancer details enlarged.
Radiation Therapy Radiation therapy, administered as both external beam radiation and brachytherapy, has been used for definitive treatment of both localized and advanced tumors.
It has also been used to downsize tumors before definitive surgical intervention. Chemotherapy and Combined Therapy The rarity of these tumors has precluded much meaningful clinical research in chemotherapeutic treatment, or in chemotherapy combined with radiation or surgery. Combination chemotherapy in conjunction with radiation and surgery has produced promising outcomes in squamous carcinomas of the head and neck, anus, and penis, and may be expected to demonstrate similar benefit in squamous cancers of the urethra.
However, multinational, multiinstitutional trials are required to provide clinical data to assess the efficacy of any such treatment regimens. Prognosis Long-term survival is related to the stage of the tumor at the time of diagnosis and appears to be independent of tumor histology or grade.
Female Urethral Carcinoma
Patients with tumors of the anterior or distal urethra had better survival than those with more proximal lesions, apparently because their tumors presented earlier in their clinical course. Beginning distally, the penile urethra is comprised of the meatus and fossa metastatic cancer metastatic cancer details which is lined with stratified squamous epithelium. The pendulous urethra extends from the proximal fossa navicularis to the suspensory ligament of the penis, where it then becomes the metastatic cancer details urethra between the ligament and the urogenital membrane.
These areas are lined with stratified or pseudostratified columnar epithelium as is the short 1. This contains the external sphincter which is comprised of striated muscle fibers.
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The prostatic urethra passes through the prostate and is lined with transitional cell epithelium. The remainder occur predominantly in the fossa navicularis.
Infrequently, transitional cell carcinoma or undifferentiated tumor may predominate at the bladder neck or within the prostatic urethra.
Poorly differentiated transitional cell cancers may show some squamous characteristics.
Carcinoma of the Urethra - Holland-Frei Cancer Medicine - NCBI Bookshelf
Rarely adenocarcinoma may arise in the glands of Littre or the prostatic utricle. Metastases from distant tumor sites to the penis also occur infrequently. Figure Retrograde urethrogram demonstrating squamous carcinoma of bulbous urethra associated with a stricture.