Urethral cancer pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

Urethral cancer is a rare disease. The pathophysiology of urethral cancer depends on the histological subtypes.

Pathogenesis

Mucous cells in the urethra have the ability to turnover rapidly. It has been suggested that defect in DNA repair mechanism may cause urethral cancer.

Chronic inflammation:

Infection:

Irritation of the urethra:

Microscopic Pathology

• Female

• The female urethra is lined by transitional cell mucosa proximally and stratified squamous cells distally.
• Therefore, transitional cell carcinoma is most common in the proximal urethra
• Squamous cell carcinoma predominates in the distal urethra.
• Adenocarcinoma may occur in both locations and arises from metaplasia of the numerous periurethral glands.

• Male

• The male urethra is lined by transitional cells in its prostatic and membranous portion and stratified columnar epithelium to stratified squamous epithelium in the bulbous and penile portions.
• The submucosa of the urethra contains numerous glands.
• Therefore, urethral cancer in the male can manifest the histological characteristics of transitional cell carcinoma, squamous cell carcinoma, or adenocarcinoma.
• Except for the prostatic urethra, where transitional cell carcinoma is most common, squamous cell carcinoma is the predominant histology of urethral neoplasms.
• Transitional cell carcinoma of the prostatic urethra may be associated with transitional cell carcinoma of the bladder and/or transitional cell carcinoma arising in prostatic ducts.