Human papillomavirus type 16 associated with multifocal transitional cell carcinomas of the bladder in two transplanted patients

This report describes two cases of rapidly progressive, multifocal transitional cell carcinomas of the bladder that developed in two patients after renal and cardiac transplantation, respectively. In both cases human papillomavirus (HPV) type 16 DNA was detected using the polymerase chain reaction DNA amplification method. To our knowledge, this HPV type has not been previously described in multifocal bladder transitional cell carcinoma in transplanted patients. Our findings suggest that HPV may play a major role in the development of rapidly progressive, multifocal transitional cell carcinoma in immunosuppressed patients.     

Primary transitional cell carcinoma of the female urethra with features of clear cell adenocarcinoma

Primary malignant urethral neoplasms are unusual in women. Those of mixed histologic type are so rare as to define adequate documentation. We report the case of an elderly black woman with an urethral carcinoma which had features of a transitional cell carcinoma as well as clear cell adenocarcinoma. The histologic and ultrastructural features are presented and the histogenesis is discussed. Although the patient had both high grade and high stage disease and failed initially after external beam radiation therapy, she is alive and well, without evidence of recurrent disease, 19 months after anterior exenteration.     

Primary transitional cell carcinoma of the male urethra: report of a case

A case of primary transitional cell carcinoma of the male urethra is reported. A 24-year-old man, who complained of tumor of the urethral orifice with hypospadias, was admitted to our Hospital on November 30, 1983. Urethrocystoscopy and biopsy revealed grade 1 papillary transitional cell carcinoma of the anterior urethra. Partial resection of anterior urethra including tumor was performed on December 20, 1983. Histopathological diagnosis revealed grade 2 transitional cell carcinoma without submucosal invasion. Postoperatively, the patient was treated with Tegafur and Krestin as adjuvant immuno-chemotherapy. The patient has shown no evidence of disease for 3 years after surgery. There have been reported 23 cases of primary transitional cell carcinoma of the male urethra in Japan.     

Intravesical bacillus Calmette-Guerin therapy for in situ transitional cell carcinoma involving the prostatic urethra

A total of 23 patients presenting with multifocal superficial bladder cancer and concomitant in situ transitional cell carcinoma of the prostatic urethra (mucosal in 19 and ductal in 4) underwent transurethral resection and intravesical bacillus Calmette-Guerin therapy. Median followup was 51.6 months (range 6 to 105 months). Of the 23 patients 13 (48 per cent) had a complete response with a median followup of 43.7 months without recurrence. Progression of some type (local, muscle invasion or metastasis) occurred in 10 patients (44 per cent); none occurred in the prostatic urethra. Median interval free of progression was 55.7 months; 7 of 10 patients required cystectomy for progression or refractory disease in the bladder (prostate negative for transitional cell carcinoma). A trial of complete transurethral resection plus intravesical bacillus Calmette-Guerin is a viable alternative to immediate radical cystectomy for patients with mucosal and/or ductal involvement of the prostatic urethra with in situ transitional cell carcinoma.     

膀胱移行细胞癌HPV的表达与肿瘤细胞空穴症的对比研究

为了探究高危型ＨＰＶ与膀胱癌发生发展的关系，证实细胞空穴症乃ＨＰＶ感染的病理组织学表现。采用ＰＣＲ技术检测４８例明显细胞空泡化的膀胱移行细胞癌石蜡标本ＨＰＶＤＮＡ。结果：４０例阳性（８３．３％），其中强阳性８例。结果表明细胞空穴症是人移行细胞、鳞状细胞ＨＰＶ感染的病理形态学特征，膀胱移行细胞癌细胞空穴症与高危型ＨＰＶ密切相关，高危型ＨＰＶ感染是膀胱癌的病因之一。     

Conservative treatment of superficial transitional cell carcinoma of prostatic urethra with intravesical BCG

We reviewed 125 male patients treated with a six-week course of intravesical bacillus Calmette-Guerin (BCG) for superficial transitional cell cancer (TCC) of the bladder that was associated with mucosal involvement of the prostatic urethra in 15 cases. In 13 of these cases, there was a sustained complete response in both the bladder and the prostate. Among the other 110 patients, in 14 TCC developed in the prostate from one to fifty-three (mean 15) months after completion of BCG. Six of these 14 had had complete response in the bladder. Recurrent TCC in the prostate was seen in only 4 percent and 6 percent of patients who had prostatic urethritis on cystoscopy and prostatic granulomas on biopsy, respectively. In contrast, recurrence was observed in 14 percent of those without urethritis and in 44 percent of those without granulomas. Transurethral resection of the prostate (TURP) prior to BCG did not appear to influence tumor recurrence in the prostate. However, after BCG, 3 patients with recurrent TCC in the prostate had complete local response after TURP alone. Further, prostatic urethritis (73%) and prostatic granulomas (60%) were more frequent among patients who had TURP prior to BCG than in those without TURP (33% and 27%, respectively). Superficial TCC of the bladder associated with mucosal involvement of the prostatic urethra can be treated successfully with intravesical BCG. In addition, our results suggest that intravesical BCG has a prophylactic effect on tumor recurrence in the prostate, and that TURP may have an important role by removing present disease and by facilitating the development of an effective biologic response to BCG in the prostate. TCC in the prostate is a significant cause of relapse, and frequent surveillance of the prostatic urethra should be performed in conservatively treated patients with superficial bladder cancer.     

Primary transitional cell carcinoma of anterior male urethra: a rare case.

We report a rare case of primary transitional cell carcinoma in a man aged 56 years old. Approximately 600 cases of primary carcinoma of the male urethra have been accumulated until today (1). The 30 to 50 per cent of these neoplasms originate in the anterior urethra and only the 15 per cent are of the transitional cell type (2).     

Long-term followup of initial Ta grade 1 transitional cell carcinoma of the bladder

PURPOSE: We evaluate the long-term outcome of initial Ta grade 1 transitional cell carcinoma. MATERIALS AND METHODS: A total of 152 patients with initial Ta grade 1 bladder tumor were followed for a mean of 76 months (range 6 to 241). Recurrence was defined as positive findings on cystoscopy or biopsy. Progression was defined as an increase in tumor grade or stage. RESULTS: Tumor recurrence in 83 of 152 patients (55%) was noted within 12 months of followup in 38 patients (46%), between 12 and 24 in 11 (13%), and between 24 and 60 in 22 (27%). A significant number of recurrences (12, 14%) were diagnosed more than 60 months after the first tumor. Of 83 patients with recurrence 31 (37%) had progression, including 21 to grade 2 and 2 to grade 3 disease. Carcinoma in situ was diagnosed in 3 patients and 5 had muscle invasive disease. Progression occurred more than 24 months after initial diagnosis in 20 patients and more than 60 months after first tumor event (2 had carcinoma in situ and 2 had muscle invasive disease) in 12. CONCLUSIONS: Ta grade 1 bladder transitional cell carcinomas have a high recurrence rate and progression is not uncommon. These findings warrant close long-term followup, even when in some settings the trend is to discontinue followup after 5 years without any abnormal findings.     

The management of stage T1 grade 3 transitional cell carcinoma of the bladder

The number of Mini‐Reviews per issue is being increased to three for the foreseeable future. As mentioned before, I believe they add to the reader‐friendliness of the journal, and are enjoyable and informative. This month, the controversial topics of T1 G3 bladder cancer, surgery for penile fractures and managing patients on warfarin are dealt with. I hope that readers will feel free to write to me if they have strong feelings about these or any other subjects in the Journal.     

Glassy cell carcinoma of the urethra

Glassy cell carcinoma is a poorly differentiated form of adenosquamous carcinoma that has never been reported in the urinary tract. We present the first case of primary glassy cell carcinoma of the urethra in a 48-year-old woman. She presented with a newly developed bulky mass protruding from her urethra. A biopsy of this mass revealed sheets of large polygonal cells with a "ground-glass" cytoplasm among a heavy inflammatory infiltrate, establishing the diagnosis of glassy cell carcinoma of the urethra. Treatment of her tumor included a combined surgical and chemotherapeutic approach.     

Clinical study of grade 3, superficial transitional cell carcinoma of the urinary bladder]

PURPOSE: To evaluate the treatment of grade 3 superficial (stage pTa and pT 1) transitional cell carcinoma (T.C.C.) of the urinary bladder, retrospective analysis was performed with special reference to tumor prognostic factors. MATERIALS AND METHODS: From July 1971 to september 1995, 51 cases with grade 3 superficial T.C.C. of the urinary bladder were treated. The survival rates and prognostic factors of these patient were analyzed. RESULTS: Five year survival rate of grade 3, superficial tumors was 92.3% and showed significantly better prognosis compared to patients with pT 2 and pT 3 tumors of grade 3 (p < 0.001). As a initial treatments, transurethral resection (TUR) was conducted in 45 patients (88%). Intravesical recurrence was observed in 20 of 45 patients (44%) and 12 of 20 patients (60%) were recurred within 1 year. Non-recurrent rates of the patients treated with TUR were 69.6% at 1 year, 58.8% at 3 year, 49.7% at 5 year, respectively. No significant differences were noted regarding factors of tumor size, figures and a number of tumor. Of the 51 patients, 10 (19.6%) progressed beyond stage T 2 and 6 died with the disease. Survival rates at 10 years follow up in patients with non-papillary and papillary tumor were 57.1% and 97.8%, respectively. CONCLUSION: These results suggested that TUR should be performed as a initial treatment for the patients with grade 3 superficial T.C.C. of the urinary bladder. However, non-papillary tumors should be considered of more intensive treatment like as radical cystectomy, adjuvant chemotherapy or irradiation.     

Transitional cell carcinoma of the anterior urethra

We report a case of transitional cell carcinoma arising in the anterior urethra, a portion of the male urethra ordinarily lined by squamous epithelium. This is the 4th case of transitional cell carcinoma of the distal urethra to be reported. The neoplasm metastasized to superficial inguinal lymph nodes.