Carcinoma of the Urethra

Publication date: Available online 18 August 2017
Source:Human Pathology
Author(s): Miao Zhang, Adebowale J. Adeniran, Raghunandan Vikram, Pheroze Tamboli, Curtis Pettaway, Jolanta Bondaruk, Jinsong Liu, Keith Baggerly, Bogdan Czerniak
Primary carcinomas of the urethra are rare and poorly understood lesions, hence their clinical and pathologic spectrum is not completely defined. We analyzed a series of 130 primary urethral tumors and classified 106 of them as primary urethral carcinomas. The age at diagnosis of patients with primary urethral carcinomas ranged from 42–97years (mean: 69.4yrs.; median: 70yrs). There were 73 males and 33 female patients with a ratio of 2.2:1. In male patients the tumors most frequently developed in the bulbous-membranous segment of the urethra. In female patients the entire length of the urethra was typically involved. Microscopically, they were poorly differentiated carcinoma with hybrid squamous and urothelial features and developed from precursor intraepithelial conditions such as dysplasia and carcinoma in situ, which were frequently present in the adjacent urethral mucosa. High risk HPV infection could be documented in 31.6% of these tumors. Follow-up information was available for 95 patients. Twenty-three patients died of the disease with a mean and median survival of 39 and 21months respectively. Urethral carcinomas are aggressive tumors with high propensity for regional and distant metastases with mean and median survival of 39 and 21months respectively. Our observations have important implications for the management of patients with primary carcinoma of the urethra by defining them as a unique entity linked to HPV infection.



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