FEMALE URETHRAL ADENOCARCINOMA - EVIDENCE FOR MORE THAN ONE TISSUE OFORIGIN

Adenocarcinoma of the female urethra accounts for 10% of all urethral cancers. Controversy continues to exist over the origin of primary ure thral adenocarcinomas. The periurethral (Skene's) glands appear to be the homologues of the male prostate as defined by authors evaluating c adaver-derived periurethral glands pathologically and immunohistochemi cally (prostate-specific antigen (PSA)). It is traditionally assumed t hat the origin of female urethral adenocarcinoma is the Skene's gland. However, no one has evaluated a series of primary urethral adenocarci nomas in an effort to scrutinize this assumption. We, therefore, evalu ated 13 primary adenocarcinomas of the female urethra comparing histol ogic and immunohistochemical characteristics. Tumors were classified i nto two major histologic groups: columnar/mucinous (11) and clear cell (2). Excluding one case, the columnar/mucinous tumors resembled eithe r endometrial or colonic adenocarcinoma. The exception was a case bear ing a striking resemblance to prostatic adenocarcinoma. Immunohistoche mical results revealed positive PSA staining for this tumor alone. The patient's preoperative serum PSA was elevated, but rapidly declined p ostoperatively. Based on immunohistochemical findings and the presence of distinct histologic subtypes (columnar/mucinous, clear cell), it a ppears that female urethral adenocarcinoma has more than one tissue of origin with a minority arising from the Skene's glands. (C) 1995 Acad emic Press, Inc.