title: Fine needle aspiration of urethral recurrence of urothelial carcinoma after radical cystectomy presenting as a perineal mass: a case report.
abstract: BACKGROUND
  Recurrence of urothelial (transitional cell) carcinoma in the urethra after cystectomy for invasive urothelial carcinoma is relatively uncommon. It is also uncommon for the recurring urethral tumor to present as a painful perineal mass. Fine needle aspiration (FNA) can be used to evaluate such perineal lesions and confirm tumor recurrence.
  
  
  METHODS
  A 5-cm-diameter mass was found in the perineum of a 63-year-old man 1 year after radical cystoprostatectomy for invasive urothelial carcinoma of the urinary bladder. The mass was detected on pelvic computed tomographic scanning. FNA cytology showed numerous urothelial carcinoma cells of high grade displaying squamous cell differentiation mimicking the histopathologic findings of the primary tumor found on cystectomy. Diagnosis of recurrent urothelial carcinoma was rendered. The FNA in this case spared the patient an open biopsy.
  
  
  CONCLUSIONS
  Mass lesions arising in the perineum of patients who underwent cystectomy for urothelial carcinoma should raise the suspicion of urothelial carcinoma recurrence. Evaluation of perineal masses for recurrence of urothelial carcinoma can be made on FNA without the need for open biopsy.
authors.affiliation: Department of Pathology, State University of New York, Downstate Medical Center at Brooklyn, Brooklyn, USA. oalagha@healthcare.uiowa.edu
authors.forename: Osama M
authors.initials: OM
authors.lastname: Al-Agha
authors.forename: Samer N
authors.initials: SN
authors.lastname: Khader
authors.forename: Antonio
authors.initials: A
authors.lastname: Cajigas
authors.forename: William
authors.initials: W
authors.lastname: Blank
authors.forename: Neil
authors.initials: N
authors.lastname: Grafstein
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Seymour
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000473:pathology*; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D014523:Urethral Neoplasms / Q000175:diagnosis / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D019459:Urothelium / Q000473:pathology*