title: Adenocarcinoma of the paraurethral glands: a case report.
abstract: Adenocarcinoma of the paraurethral glands represents a very rare neoplasm of the urinary tract. Due to the rarity of this disease, there is no standard therapeutic approach. We report a case of adenocarcinoma of the paraurethral glands in a 56-year-old woman, presenting with abnormal serous vaginal discharges. The radiologic examination revealed a 5-cm mass around the urethra, which underwent surgical resection. After surgical resection, the histology revealed a moderately differentiated adenocarcinoma, probably arising from the paraurethral glands. One month later, a pelvic recurrent mass was radiologically diagnosed; consequently, an anterior pelvic exenteration with lymph node dissection was performed. Histological examination revealed a moderately differentiated adenocarcinoma, with glandular and micropapillary architecture, with multiple lymph node metastases. The absence of modifications such as urethritis cystic glandularis on the urethral mucosa, as well as the lack of a lesion in situ, associated with the immunohistochemical expression of PAX8 and negativity for GATA3 and S100p, suggested that the adenocarcinoma originated from the paraurethral glands rather than from the urethral mucosa. Post-surgery CT scans revealed no evidence of metastatic disease. The patient received 6 courses of adjuvant chemotherapy with carboplatin and paclitaxel. One year after the pelvic exenteration, because of inguinal lymph node progression, an inguinal lymphadenectomy was performed. Four months later, a TC-PET revealed a multidistrectual lymph node and a lung micronodule disease progression. Invasive micropapillary carcinomas have been characterized as a rare distinctive variant of carcinomas in several anatomic sites and are distinguished by a marked tendency to lymphovascular invasion, justifying the association with high-stage disease and poor prognosis. In the present case, both the poor prognosis connected with micropapillary structure and the lymph node involvement, encouraged adjuvant cisplatinum-based chemotherapy.
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy. fmassari79@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Ciccarese
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Modena
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Maines
authors.affiliation: Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Segala
authors.affiliation: Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Luchini
authors.affiliation: Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Marcolini
authors.affiliation: Urology Clinic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cavicchioli
authors.affiliation: Urology Clinic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cavalleri
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bria
authors.affiliation: Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.affiliation: Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.affiliation: Urology Clinic, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.affiliation: Medical Oncology, Azienda Ospedaliera Universitaria Integrata (A.O.U.I.), University of Verona, Verona, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Tortora
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005088:Exocrine Glands / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D014463:Ultrasonography; D014523:Urethral Neoplasms / Q000473:pathology* / Q000601:surgery