THE HISTOGENESIS OF CLEAR-CELL ADENOCARCINOMA OF THE LOWER URINARY-TRACT - CASE SERIES AND REVIEW OF THE LITERATURE

Clear cell adenocarcinoma of the lower urinary tract is a rare neoplas m whose histogenesis has not been thoroughly investigated, We have exa mined six specimens of clear fell adenocarcinomas collected from three institutions using histological, histochemical, and immunohistochemic al techniques. Results indicate that almost all clear cell adenocarcin omas of this region express morphological and antigenic features, sugg esting mullerian differentiation, and that mullerian differentiation i s not a feature of either nonclear cell adenocarcinomas or normal fema le paraurethral glands. Including the authors' six specimens, 46 speci mens have been reported in the available English literature. The accum ulated experience confirms the initial impression that these tumors de velop predominantly in the urethras of women and occur over a wide age range. Despite high stage at diagnosis, most patients have been alive with no evidence of disease when reported, a prognosis that seems to apply regardless of length of follow-up. (C) 1996 by W.B. Saunders Com pany