Clear cell adenocarcinoma of the male urethra: clinical case report

ABSTRACT

Primary clear cell adenocarcinoma of the urethra is a rare malignancy and most of the cases described are in women. The symptomatology is similar to other tumors of the urethra. Because it is a rare malignancy and the consequent lack of trials in the medical literature, there is no data about the most appropriate treatment for this disease. We aim to describe a clinical case of primary clear cell adenocarcinoma of the urethra in a young male patient. This is a 36-year-old male diagnosed with primary clear cell adenocarcinoma of the urethra whom underwent a surgery for localized disease and about 30 months later he had a local and systemic recurrence. He was treated with platinum-based chemotherapy and presented an excellent clinical and radiological response. Although there is no optimal treatment for this malignancy, in the case of metastatic disease, systemic platinum-based chemotherapy should be considered an appropriate option.

RESUMO

O adenocarcinoma de células claras primário da uretra é uma doença maligna rara e a maioria dos casos descritos são em mulheres. A sintomatologia é semelhante a outros tumores da uretra. Por se tratar de uma neoplasia rara e a consequente falta de ensaios na literatura médica, não existem dados sobre o tratamento mais adequado para esta doença. Nosso objetivo é descrever um caso clínico de adenocarcinoma de células claras primário da uretra em um paciente jovem do sexo masculino. Trata-se de um homem de 36 anos com diagnóstico de adenocarcinoma de células claras primário da uretra que foi submetido a uma cirurgia para doença localizada e cerca de 30 meses depois apresentou recorrência local e sistêmica. Foi tratado com quimioterapia à base de platina e apresentou excelente resposta clínica e radiológica. Embora não haja um tratamento ideal para essa malignidade, no caso de doença metastática, a quimioterapia sistêmica à base de platina deve ser considerada uma opção apropriada.

Keywords:

Adenocarcinoma - Clear Cell - Urethral Neoplasms - Male Urogenital Diseases - Systemic Management.

Descritores:

Adenocarcinoma de células claras - Neoplasias uretrais - Doenças urogenitais masculinas - Manejo sistêmico.

CONFLICT OF INTEREST STATEMENT

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

ETHICAL CONSIDERATIONS

This case report received approval from the institution's research ethics committee, and has been approved under the registration number 3.846.377 and CAAE 28202020.4.0000.5650 in the Plataforma Brasil.

Publication History

Received: 09 April 2020

Accepted: 23 August 2020

Article published online:
14 May 2021

• REFERENCES

• Venyo AKG.. Clear cell adenocarcinoma of the urethra: review of the literature. Int J Surg Oncol 2015; 2015: 79235
• Cantrell BB, Leifer G, Deklerk DP, Eggleston JC.. Papillary adenocarcinoma of the prostatic urethra with clearcell appearance. Cancer 1981; Dec; 48 (12) 2661-2667
• Sun K, Huan Y, Unger PD.. Clear cell adenocarcinoma of urinary bladder and urethra: another urinary tract lesion immunoreactive for P504S. Arch Pathol Lab Med 2008; Sep; 132 (09) 1417-1422
• Visser O, Adolfsson J, Rossi S, Verne J, Gatta G, Maffezzini M. et al Incidence and survival of rare urogenital cancers in Europe. Eur J Cancer 2012; Mar; 48 (04) 456-464
• Swartz MA, Porter MP, Lin DW, Weiss NS.. Incidence of primary urethral carcinoma in the United States. Urology 2006; Dec; 68 (06) 1164-1168
• Liu SV, Truskinovsky AM, Dudek AZ, Ramanathan RK.. Metastatic clear cell adenocarcinoma of the urethra in a male patient: report of a case. Clin Genitourin Cancer 2012; Mar; 10 (01) 47-49
• Oliva E, Young RH.. Clear cell adenocarcinoma of the urethra: a clinicopathologic analysis of 19 cases. Mod Pathol 1996; May; 9 (05) 513-520
• Nakatsuka S, Taguchi I, Nagatomo T, Yamane M, Sugio K, Yoshino R. et al A case of clear cell adenocarcinoma arising from the urethral diverticulum: utility of urinary cytology and immunohistochemistry. Cytojournal 2012; 9 (01) 11
• Gandhi J, Khurana A, Tewari A, Mehta A.. Clear cell adenocarcinoma of the male urethral tract. Indian J Pathol Microbiol 2012; Jul; 55 (02) 245-247
• Janisch F, Abufaraj M, Fajkovic H, Kimura S, Iwata T, Nyirady P. et al Current disease management of primary urethral carcinoma. Eur Urol Focus 2019; Sep; 5 (05) 722-734
• Varachhia SA, Goetz L, Persad R, Naraynsingh V.. Clear cell carcinoma of the male urethra presenting as periurethral abscess with fistulae. J Pelvic Med Surg 2009; Jul/Aug; 15 (04) 221-223
• Lewis S, Pal M, Bakshi G, Ghadi YG, Menon S, Murthy V. et al Case reports High-dose-rate brachytherapy - a novel treatment approach for primary clear cell adenocarcinoma of male urethra. J Contemp Brachytherapy 2015; Jun; 3 (03) 248-251
• Gogus C, Baltaci S, Orhan D, Yaman O.. Clear cell adenocarcinoma of the male urethra. Int J Urol 2003; Jun; 10 (06) 348-349
• Seseke F, Zöller G, Kunze E.. Clear cell adenocarcinoma of the male urethra in association with so-called nephrogenic metaplasia. Urol Int 2001; 67 (01) 104-108
• Sugimura R, Kawahara T, Noguchi G, Takamoto D, Izumi K, Miyoshi Y. et al Clear cell adenocarcinoma of the prostatic urethra: a case report. IJU Case Rep 2018; Nov; 2 (01) 19-22