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Cancer pain remains a significant clinical problem worldwide. Cancer pain causes are multifactorial and complex and varying with a variety of factors and processes related both to the tumor process and to the host itself. Even though the quality of pharmacologic pain management has improved in the last decades, 1 in 3 patients do not receive pain medication appropriate for the intensity of experienced pain. Chronic cancer pain in urologic patients has different traits, since this carcinoma might originate from various organ:, prostate, kidneys, adrenal glands, urinary bladder or the penis. Urogenital neoplasm very often metastasized into the bones (spine, pelvis and head bones) and they are associated with pathological fractures, hypercalcemia, and neurological deficits, which lead to a significant reduction in quality of life. Pain induced by bone metastases is nociceptive pain, but may also be associated with neuropathic pain if the tumor performs compression or invasion of the nerve, spinal cord or nerve plexus. In 70-90% of urological cancer patients pain can be adequately relieved by consistent adherence to the WHO cancer pain recommendations. However, additional pain relief therapies, such as radiation and psychosocial treatment of these patients have to be considered.

Primary male genital melanomas are very rare; they are associated with high mortality and late detection. Scrotal melanoma is the least common presentation and only 23 cases have been reported. Herein, the authors present a 30-year-old patient with stage IIIC (T4b, N2a, M0) scrotal melanoma in order to report the characteristics, treatment, and outcome, as well as to emphasize the importance of examination of the genitals, education of patients about self-examination and destigmatizing genital lesions to increase the likelihood of earlier detection.

Management of genitourinary (GU) cancers is improving rapidly with the development of immunotherapy agents, especially anti-PD-1/anti-PD-L1 therapies. Large studies have shown better outcomes for the treatment of these patients, leading to new drug approvals and recent changes in standards of care in renal, prostate and bladder cancer. We performed a review of recent studies assessing efficacy of immuno-oncology therapies in GU cancers. New results are summarized and next ways of development of clinical research are discussed as the use of such therapies will soon be assessed in first-line or adjuvant settings.

Objective Unlike for bladder cancer, the impact of regional lymph node dissection for upper tract urothelial carcinoma is unclear. We explored whether patient survival was influenced by systematic regional lymph node dissection, using resection templates according to the main tumor location, during radical nephroureterectomy for upper tract urothelial carcinoma. Methods The systematic regional lymph node dissection group was defined as cases in which the dissection of nodes and surrounding tissues followed the established template, and the non-systematic regional lymph node dissection group as cases undergoing limited or no lymph node dissection. We performed radical nephroureterectomy on 98 consecutive patients with various stages of upper tract urothelial carcinoma from May 1994 to September 2014 at our institution. Of these, 77 patients with cTanyN0M0 of upper tract urothelial carcinoma undergoing radical nephroureterectomy were grouped into systematic regional lymph node dissection or non-systematic regional lymph node dissection cohorts according to the extent of dissection, and their outcomes compared. Results Forty-four patients were categorized as systematic regional lymph node dissection and 33 as non-systematic regional lymph node dissection, including 17 with more limited nodal dissection and 16 with no nodal dissection. Five-year recurrence-free survival and cancer-specific survival were significantly higher in the systematic regional lymph node dissection (93% and 94%, respectively) than in the non-systematic regional lymph node dissection group (75% and 77% recurrence-free survival and cancer-specific survival, respectively). Further, 5-year recurrence-free survival and cancer-specific survival of muscle-invasive upper tract urothelial carcinoma (pT2-4) were significantly higher in the systematic regional lymph node dissection (87% and 91%, respectively) than in the non-systematic regional lymph node dissection group (59% and 62%, respectively) (P = 0.0237 and P = 0.0224). Neither recurrence-free survival nor cancer-specific survival was significantly prolonged by systematic dissection in patients with pTis-1 histology. Conclusions Systematic regional lymph node dissection during radical nephroureterectomy for cTanyN0M0 upper tract urothelial carcinoma patients has a significantly beneficial impact on survival compared with patients undergoing more limited dissection, especially in the cases involving muscle invasion.

This review article aims to provide an overview on of diffusion-weighted MR imaging (DW-MR imaging) in the urogenital tract. Compared with conventional cross-sectional imaging methods, the additional value of DW-MR imaging in the detection and further characterization of benign and malignant lesions of the kidneys, bladder, prostate, and pelvic lymph nodes is discussed as well as the role of DW-MR imaging in the evaluation of treatment response.

The genitourinary tract is a common site for new cancer diagnosis, particularly for men. Therefore, cancer-containing specimens are very common in surgical pathology practice. However, many benign neoplasms and nonneoplastic, reactive, and inflammatory processes in the genitourinary tract may mimic or cause differential diagnostic challenges with malignancies. Emerging clinicopathologic, immunohistochemical, and molecular characteristics have shed light on the pathogenesis and differential diagnosis of these lesions. This review addresses differential diagnostic challenges related to benign genitourinary tract lesions in the kidney, urinary bladder, prostate, and testis, with emphasis on recent advances in knowledge and areas most common in diagnostic practice.

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The diagnosis and treatment of rare genitourinary tumors is inherently challenging. The Rare Diseases Act of 2002 initially defined a rare disorder as one that affects fewer than 200,000 Americans. The lack of widely available clinical guidelines, limited research funding, and inaccessible clinical trials often lead to difficulty with treatment decisions to guide practitioners in rendering effective care for patients with rare genitourinary cancers. This article will discuss basic tenets of diagnosis and treatment as well as recent developments and clinical trials in rare non-urothelial bladder cancers and penile squamous cell cancers.

Suspicious malignant supraclavicular lymphadenopathy provides a challenge for diagnosis and treatment. The wide variety of primary tumours that metastasise to this region should alert the clinician to look beyond the head and neck, particularly if it is the only site in the neck with suspected disease. As metastatic spread to these nodes from primaries not in the head and neck often indicates wide spread disease, neck dissection is controversial. In this article we review the lymphatic anatomy and discuss the investigation of supraclavicular lymphadenopathy. We discuss the evidence for the management of the neck in patients with subclavicular primary cancers (excluding lymphoma and melanoma) and the role of neck dissection.

Diffusion weighted magnetic resonance imaging (DW MRI) appears to hold promise as a non invasive imaging modality in the detection of early microstructural and functional changes of different organs. DW MRI is an imaging technique with a high sensitivity for the detection of a large variety of diseases in the urogenital tract. In kidneys DWMRI has shown promise for the characterization of solid lesions. Also in focal T1 hyperintense lesions DW MRI was able to differentiate hemorrhagic cysts from tumours according to the lower apparent diffusion coefficient (ADC) values reported for renal cell carcinomas. Promising results were also published for the detection of prostate cancer. DW MRI applied in addition to conventional T2 weighted imaging has been found to improve tumour detection. On a 3 T magnetic resonance unit ADC values were reported to be lower for tumours compared with the normal appearing peripheral zone. The combined approach of T2 weighted imaging and DW MRI also showed promising results for the detection of recurrent tumour in patients after radiation therapy. DW MRI may improve the performance of conventional T2 weighted and contrast enhanced MRI in the preoperative work up of bladder cancer as it may help in distinguishing superficial from muscle invasive bladder cancer which is critical for patient management. Another challenging application of DW MRI in the urogenital tract is the detection of pelvic lymph node metastases. As the ADC is generally reduced in malignant tumours and increased under inflammatory conditions reduced ADC values were expected in patients with lymph node metastases. © 2009 International Cancer Imaging Society.

Introduction: Leiomyoma is a benign bladder tumor accounting for ~0.43% of all bladder tumors.1,2 There are ~200 reported cases, with ~75% occurring in females during their third to sixth ...

We integrated all the eligible studies and investigated whether the TNF-α 308G/A polymorphism correlates with urogenital cancer risk. Tumor necrosis factor-α (TNF-α) is a risk factor for some urogenital cancers; however, in prostate and bladder cancers the results are controversial. PubMed, EMBASE, Web of Science, the Cochrane Library, the Chinese Biomedical Literature Database, and the Wanfang Database were searched for all case-control studies on the relationship between the TNF-α 308G/A polymorphism and susceptibility to urogenital cancer between January 1994 and January 2015. The pooled odds ratio with 95% confidence interval was calculated to assess the associations. A total of 504 articles were found, 39 of which involved 11,613 cases and 12,542 controls that fulfilled the inclusion criteria. Overall, the TNF-α 308G/A polymorphism was significantly associated with the risk of urogenital cancer. In the subgroup analysis for different cancer types, significant associations were found in cervical cancer and urothelial carcinoma, while our meta-analysis indicated that there were no significant associations between the TNF-α 308G/A polymorphism and prostate, bladder, or renal cancers. When stratified by ethnicity, significant associations were observed in Caucasian populations, whereas no significant associations were found in African-Americans, Asians, or mixed populations. Furthermore, carriers of the -308A allele among the hospital-based case-control group were at a high risk of urogenital cancer. Our meta-analysis showed that the TNF-α 308G/A polymorphism was significantly associated with urogenital cancer risk, particularly in the Caucasian and hospital-based populations.

Introduction: Transitional cell cancer is the fourth most frequent carcinoma. The upper urinary tract is affected in only 5% to 10%. An affection of the renal pelvis is observed twice as o...

We describe treatment and reconstruction in patients after surgery for extramammary Paget's disease of the penis and scrotum. We also investigated whether this disease causes an increased risk of undiagnosed visceral malignancy.We reviewed the databases at our institution from 1996 to 2000 and identified 6 men 67 to 87 years old (mean age 76). In addition, we reviewed the literature on the clinical and pathological features of this disease.In our 6 patients scrotal involvement was present in 83% and penile extramammary Paget's disease was present in 33%. Each man underwent wide local excision and large skin defects were immediately reconstructed with split-thickness skin grafts. In 1 case extramammary Paget's disease had spread to the superficial inguinal nodes. At a mean followup of 29 months there has been no local recurrence and internal malignancy has not been diagnosed. Our literature review revealed 13 patients with penoscrotal extramammary Paget's disease and visceral malignancy, including 12 (92%) with malignancy of the genitourinary system.Extramammary Paget's disease of the penis and scrotum is a rare disease that can be managed by excision and immediate reconstruction with skin grafting or a local skin flap. Disease may spread to the regional lymph nodes. Although genitourinary cancer may accompany penoscrotal extramammary Paget's disease, an extensive search for cancer of the thorax or abdomen may be unnecessary because only 1 reported case of colon cancer has been associated with penile or scrotal extramammary Paget's disease.

Primary seminal vesicle (SV) adenocarcinoma is a rare tumor. A small amount of data about the role of imaging to detect tumor recurrence is available. We report the case of a 58-year-old patient with primary SV clear-cell well-differentiated adenocarcinoma. Clinical and instrumental examinations were negative for the 32 months after treatments when computed tomography scan, [(18)F]fluoro-D-glucose positron emission tomography/computed tomography and pelvic magnetic resonance imaging showed the appearance of a lesion in the left perineal muscle suspected for recurrence. Patient was symptomless. Cytology of the suspected lesion confirmed SV adenocarcinoma recurrence. The combined approach, using radiological and nuclear medicine techniques, seems to be effective in the follow-up of SV adenocarcinoma. Technological advances, together with awareness of this rare tumor, have the potential of improving patients outcomes not only by providing earlier detection and accurate staging, but also by detecting recurrence and thereby avoiding delays and therapeutic dilemmas.

Since 1985 a special work group involved in the coordination of hospital cancer registries in Germany (AKKK) has been collecting, storing and analysing data on tumour patients, received from cancer centres, oncological departments and specialised practices. The documentation of tumour patients is based, among other things, on information concerning localisation, histological findings and tumour spread. The data are stored in a central database administered by the work group. At present it contains data on approximately 500,000 oncological patients. In the period from 1987 to 1992, 56,013 initial entries were made concerning patients with urological tumours. Of these cases, tumours of the kidney (n = 11,424) constituted 20.4%. In 94.6% of the cases, histological investigation revealed a renal cell carcinoma-pT1: 5.8%; pT2: 53.6%, pT3: 37.2% and pT4: 3.4%. Tumours of the urinary bladder (n = 16,246) constituted 29.0% of all urological tumours. In 93.8% of the cases a transitional cell carcinoma was detected-pTis: 1.0%; pTa: 36.9%; pT1: 29.6%; pT2: 16.9%; pT3: 11.4%; pT4: 4.4%. Transitional cell carcinomas of the ureter or of the collecting system (n = 1,846) constituted 3.3% of the cases. The proportion of testicular tumours (n = 6,594) amounted to 11.8%; 53.6% of these germ-cell tumours (n = 6,281) were seminomas and 46.6% were non-seminomas. In all, 66.3% of the cases were lymph-node negative. Tumours of the prostate (n = 19,903) constituted 35.5% of the cases. In the period from 1987 to 1992, the proportion of lymph-node-positive prostate carcinomas decreased from 39.8% to 16.2%. The detailed analysis of these data shows how the hospital cancer registries can support the discussion regarding diagnosis and therapy of urological tumours.

Leiomyomata are benign neoplasms that are rarely encountered in the genitourinary tract outside the uterus. Pathological confirmation is always needed for definitive diagnosis, in order to rule out malignancies such as leiomyosarcoma. In cases of small leiomyomata, a surveillance strategy can be suggested, although the preferred approach is complete resection. Prognosis seems to be excellent, but available data are based on few, inconsistent series, as is often the case with rare neoplasms. This article presents long-term follow-up data from the most heterogeneous series, in terms of anatomical location, currently available.The present series of 33 genitourinary leiomyomata was retrieved after joining the "rare urogenital neoplasm" registry of two Italian regions. Two pathologists jointly reviewed all pathological slides and confirmed the diagnosis of leiomyoma.Sixteen cases were localized to the scrotum, eight to the bladder, five to the kidney, two to the prostate, one to the urethra and one to the penis. Mean patient age was 58.4 (range 32-80) years. Mean follow-up was 15.5 (range 2-20) years.In this highly heterogeneous series, the disease showed excellent long-term recurrence- and progression-free interval. The accuracy of pathological diagnosis, along with the indolent long-term course, make the role of active surveillance amenable for asymptomatic cases, particularly where surgery may result in overtreatment.

Patient Male, 59. Final diagnosis Neuroendocrine carcinoma of urinary bladder. Symptoms Dysuria • hematuria. Medication - Clinical procedure MRI • cystoscopy. Specialty Urology • oncology. Objective Rare disease. Background Neuroendocrine carcinomas of the genitourinary tract are rare but distinct and important entities because they are very aggressive tumors and are usually advanced or metastatic at the time of diagnosis. A high index of suspicion must be held by the pathologist viewing the specimen, as it can easily be misdiagnosed as a high grade urothelial carcinoma. Specific, proven treatment algorithms have been formulated over the years for the latter, whilst neuroendocrine carcinomas of the genitourinary tract are rare and treatment regimes have not yet been proven to show a significant improvement in survival in the majority of cases, so accurate diagnosis is important. Case report We report the case of a 59-year-old man who presented with a short history of dysuria and frank hematuria. Imaging and cystoscopy revealed a large exophytic mass in the base of the urinary bladder, which extended into the bladder neck. Metastatic deposits were already present in his liver and vertebrae. Histology revealed a neuroendocrine carcinoma. Conclusions A comprehensive review of the existing literature regarding this rare but aggressive tumor is presented, including advances in classification, pathogenesis, and treatment.

The occurrence of genitourinary tumors in the relatives of a population-based series of 218 children diagnosed with renal tumors was investigated. Family data on 92% (176 of 192) of Wilms' tumor (WT) patients and 77% (20 of 26) of other renal tumor patients were obtained. In all, 21 genitourinary tumors in first-degree relatives in 19 families were ascertained, together with 30 such tumors in second-degree relatives. Ten families were diagnosed with multiple genitourinary tumors, although none of these manifested familial WT. It is proposed that a small proportion of families of children with renal tumors has a genetic predisposition to develop genitourinary tumors and that these tumors may represent further manifestations of the pleiotropic effects of the WT1 gene or of other genes involved in WT predisposition.

Large discrepancy remains for the hormone-responsible cancers with regards to the conditions generating the optimal opportunity for cancerogenesis. In the research, altered steroid profiles were observed in patients with urogenital tract cancer diseases, namely bladder, kidney, prostate and testis ones. The presented steroid profiles from 154 subjects, including 77 urogenital tract cancer patient and 77 healthy controls were determined by liquid chromatography coupled to mass spectrometry method. Because the original experimental data obtained as a result of analytical experiment in order to interpret them in better way required the appropriate pre-treatment, the data were standardized by scaling and centering. In order to determine which samples form a collection for a high-capacity predictive model, Kennard-Stone's algorithm was used. A principal component analysis of preprocessed data provided better consistency of the steroid profiles with health status of subjects than PCA profiles without data preprocessing and showed a tendency to separate clusters of cancer patients from healthy subjects. The discriminant analysis was also performed and the percent of correct classification of cancer patients and control group was calculated. Finally, detailed studies examined the role of steroid profiles measured in urine, and considered as potential biomarkers related to urogenital cancer and associated renal dysfunctions.

Review on Vulva and Vagina tumors: an overview, with data on clinics, and the genes involved.

Ovarian tumours are subdivided into 5 main categories according to the World Health Organization's classification system: Epithelial tumours, which account for about 75% of all ovarian tumours, and 90-95% of ovarian malignancies. Sex cord-stromal tumours, which account for about 510 % of all ovarian neoplasms. Germ cell tumours, which account for about 15-20 % of all ovarian neoplasms. Metastatic tumours, accounting for about 5% of ovarian malignancies, and usually arise from breast, colon, endometrium, stomach and cervical cancers. Other, a small number of other types of neoplasms which develop from ovarian soft tissue or nonneoplastic processes.

It is an heterogeneous entity, comprising at least two types: type I: endometrioid carcinoma: preand perimenopausal, estrogen dependent, associated to endometrial hyperplasia, low grade, indolent behaviour, representing about 80 % of the cases type II: serous carcinoma: post-menopausal, estrogen independent, associated to atrophic endometrium, high grade, aggressive behaviour, representing about 10 % of the cases among other histologic types, type I includes mucinous and secretory carcinomas, whereas type II includes clear-cell carcinomas and adenosquamous carcinomas.

Between 1970 and 1990, 23 patients were treated for embryonal rhabdomyosarcoma of the bladder (8), prostate (7), uterus (4) or vagina (4). One girl underwent exenteration without chemotherapy. Of the patients 22 received chemotherapy as initial treatment. There was 1 treatment-related death. A total of 21 patients completed the first phase: 4 were treated with chemotherapy alone and 17 subsequently underwent an operation. Three boys underwent total cystoprostatectomy and local resection was performed in 14 patients. One boy was lost to followup. Mean followup was 11.2 +/- 6.3 years in 15 survivors. Complete remission was achieved in 19 patients, while 11 (53%) had relapse at an interval of 3 to 102 months. Of 13 patients with bladder and prostate tumors 8 had relapse and 7 survived. Of 8 patients with uterus and vagina tumors 3 had relapse and all survived. Six patients died of recurrent disease (overall mortality rate 32%). The interval from initial diagnosis until death was always less than 5 years. The mortality rate was greater in boys (5 of 12) than in girls (1 of 9). Preservation of pelvic organs in girls was 75%, while of the boys 44% retained the bladder. Since disease relapsed in patients in whom no tumor was found in the resection specimen after chemotherapy, we conclude that a conservative surgical approach combined with chemotherapy towards urogenital rhabdomyosarcoma is justified. Although late relapses do occur, they can usually be salvaged by a combination of chemotherapy, radiotherapy and surgery.

PURPOSE: Tumor banks have the primary responsibility for collecting, cataloging, storing and disseminating samples of tissues, cells and fluids, which are used by researchers to identify diagnostic molecular markers, prognostic indicators and therapeutic targets. The objective of this review was to describe a simple, reliable and reproducible protocol for obtaining and storing samples of urological tumors. MATERIALS AND METHODS: Urogenital tumor tissues were collected by the surgeons from the Urology Division of University of Sao Paulo Medical School. The obtained surgical specimens were immediately placed in liquid nitrogen, dry ice or in a tube containing RNAlater ®, and then stored by cryopreservation (-80°C). A mirror fragment was fixed in 10% formalin processed routinely and embedded in Paraplast®. RESULTS: We developed a protocol for the collection, cataloging, storage, conservation and use of tumor samples. During a period of one year the Urological Tumor Bank of the Urology Division stored 274 samples of prostate, bladder, kidney, penis and testicle tumors of different histological types, 74 urine and 271 serum samples. CONCLUSIONS: Having biological materials characterized and available along with the clinical patient information provides an integrated portrait of the patients and their diseases facilitating advances in molecular biology. It also promotes the development of translational research improving methods of diagnosis and cancer treatment.

Introduction: Retrocaval ureter is a rare congenital anomaly occurring in 1 in 1500 people. It is a condition in which the ureter deviates medially and passes behind the inferior vena cava...

Objectives: Photoselective laser vaporization prostatectomy (PVP) is a hemostatic procedure for men with benign prostatic hyperplasia. The study demonstrates that the modified vaporization...

We will review the 2007/2008 literature on pediatric genitourinary tumors.Newly identified constitutional epigenetic defects in Wilms tumor genes extend the understanding of Wilms tumor risk in children lacking syndromic features, and add to the complexity of the pathogenesis of these tumor suppressor genes. Pediatric renal cell carcinoma has distinct molecular characteristics and clinical associations from the adult counterpart. The pathway from PAX3-FKHR translocation to the development of rhabdomyosarcoma tumors has been further elucidated.Therapeutic strategies continue to be driven by developments in molecular diagnostics in pediatric genitourinary tumors.

Persistent mullerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism. Bilateral fallopian tubes and a uterus occur with an otherwise normal male phenotype. Testicular neoplasm in PMDS has been reported, but malignant degeneration of the remnant female genitalia has only once been reported. We present imaging, surgical specimen, and surgical pathology of the first documented case of uterine adenosarcoma of a mullerian remnant in a 14-year-old boy with PMDS presenting with gross hematuria and increasing abdominal protuberance. The child died of metastatic disease after surgical resection.

To investigate the association between genital bacterial infection and urogenital carcinoma in California sea lions (Zalophus californianus), vaginal and preputial swabs for bacterial isolation were taken from 148 free-ranging and 51 stranded California sea lions including 16 animals with urogenital carcinoma. Cytological examination of vaginal or preputial smears showed a majority (65.5%, 57/87) of animals examined had mild or no inflammation. Aerobic bacteria were isolated from 116 (78.4%) wild sea lions and 100% of stranded animals. A total of 403 isolates were identified representing 51 unique bacterial species. The median number of isolates per animal increased with age in the wild group, but there was no difference in the number of isolates per animal between wild and stranded adults. The most common bacteria isolated from the wild sea lions were Psychrobacter phenylpyruvicus (39 isolates), non-hemolytic Streptococcus (35 isolates), Corynebacterium spp. (30 isolates), and Escherichia coli (20 isolates). More bacterial species were isolated from stranded animals than wild animals (33 versus 26) and there was significantly less growth of P. phenylpyruvicus, Corynebacterium spp., and Moraxella-like spp. in the stranded animals. Beta-hemolytic Streptococcus was the only bacterium significantly associated with urogenital carcinomas in California sea lions, but only in females.

Objective: To determine the frequency and pattern of genitourinary malignancies seen at the Korle-Bu Teaching Hospital, Accra, Ghana Materials and methods: A retrospective review of genitourinary malignancies seen at the Korle-Bu Teaching Hospital from 1980 to 1990 was undertaken. Data was obtained from the operating theatre register, histopathology reports, and patient case notes. Information retrieved included age and sex of patients, organ involved and laterality where appropriate and tumour type. Results: 548 genitourinary malignancies were seen, of which 479 (87.4%) were in males and 69 (12.6%) in females. Adults comprised 93.4% and children 6.6%. The organ-specific distribution was as follows – prostate 349 (63.7%), bladder 117 (21.3%), kidney 57 (10.4%), testis 13 (2.4%), penis 10 (1.8%) and one each of the ureter and urethra. The kidney tumours comprised nephroblatoma (56.1%), adenocarcinoma (35.1%) with the rest being of urothelial origin. Of the bladder tumours, 50.4% and 44.8% were transitional cell and squamous cell carcinoma respectively. Virtually all the prostatic cancers (99%) were adenocarcinomas. Of the testicular tumours 8(61.5%) were of germ cell and 5 (38.5%) non-germ cell origin. The penile cancers were all squamous. The ureteric and urethral tumours were due to transitional cell and squamous cell carcinomas respectively. Conclusion: Prostatic carcinoma was the predominant genitourinary tumour, accounting for nearly two-thirds of cases, followed by the bladder and the kidney. Other tumours were relatively uncommon. Transitional cell carcinoma of the bladder was seen a little more commonly than the squamous type. Key Words: Prostate, Bladder, Kidney, Testis, Penis, Ureter, Urethra, Cancer, Site-specific, Histology. Resume Objectif: Determiner la frequence et la tendance des genito-urinaires maligns vus au centre hospitalier universitaire du Korle-Bu a Accra au Ghana Materiels et Methodes: Un bilan retrospectif des genito-urinaires maligns vus au cntre hospitalier universitaire de 1980 au 1990 a ete effectue. Des donnees ont ete obtenues du registre de la salle d'operation, rapports histopathologies et dossier medical des patients. Des informations recuperees sont: âge, et sexe des patients, organe impliques et lateralite, si c'est necessaire et le type de tumeur. Resultats: 548 cas des malignites genito-rinaire ont ete vus, dont 479 soit 87, 4% etaient du sexe masculin et 69 soit 12,6% etaient du sexe feminin. Des adultes constituentt 93,4% et des enfants 6.6%. La repartition specifique des organes sont representees par. prostate 349 (63,7%, la vessie 117 (21,3%), rein 57 (10,4%), testicule 13 (12,4%) penis 10 (1,8%) et chacun de uretere et uretre. Les tumeurs du rein sont representees par nephroblastome (56,1%) adenocarcinome (35,1%) et les autres etant d'origine d'urothelial. Parmi les tumeurs de vessei, 50,4% et 44,8% etaient des cellule transitionnelle et cellule carcinome du squame respectivement. Pratiquement, tous les cancers de la prostate (99%) etaient adenocarcinome. Parmi les tumeurs testiculaires 8 soit 61,5% etaient gamete et 5 soit 38,5% d'origine non gamete. Les cancers du penis etaient tous du squame. Des tumeurs ureteriques et uretrales etaient tous attribuables au cellule transitionelle et cellule carcinome du squame respectivement. Conclusion: Carcinome de la prostate etait la tumeur genito-urinaire la plus predominale, constitute presque deux tiers des cas, suivi par la vessei et le rein. Tous les autres tumeurs sont relativement peu courant. Cellule carcinome transitionelle de la vessie etait vue un peu plus frequemment plus le type du squame. West African Journal of Medicine Vol.23(2) 2004: 131-134

PURPOSE We investigated the changing patterns of urogenital cancer deaths during the past 22 years in Japan. METHODS We analyzed patients that died from cancer of the prostate, bladder and kidney between 1973-1994. Age-adjusted death rates (adjusted to the world population), standardized mortality ratios (SMR) according to each prefectures and age-specific death rates for each types of cancer were calculated and changes in these patterns were analyzed. RESULTS Age-adjusted death rates for cancer of the prostate increased from 2.29 in 1973 to 4.36 in 1994, a 1.9-fold increase. Death rates for cancer of the bladder were stable in males and declined in females. Death rates for cancer of the kidney (15 years or older) increased from 1.45 in 1973 to 2.72 in 1994, a 1.9-fold increase in males, and tended to increase in females as well. In the SMR analysis by prefecture, distribution in 1973-84 (former period) and that in 1985-94 (later period) were similar, and characteristic features were observed for each type of cancer. Age-specific death rates for cancer of the prostate and bladder rose by an index power of age, but that for cancer of the kidney reached a plateau or decreased after an index power increase to a certain age. The rate of increase in age-specific death rates (later period/former period) rose according to age, especially 70 years or older, in cancer of the prostate and kidney in both males and females. However, age-specific death rates in the later period from cancer of the bladder was higher only in patients 85 years or older, but was lower in other age groups. CONCLUSIONS Death rates for cancer of the prostate and kidney (15 years or older) tended to increase, while that of the bladder remained stable or decreased. It is expected that detection and treatment of these disease can be improved by utilizing these epidemiologic information.

Deletions within the short arm of the human chromosome 11 have been found to be involved in the genesis of several tumours, including different urogenital neoplasms. We have studied 31 male germ cell tumours (19 seminomas and 12 nonseminomas), and observed loss of heterozygosity at 11p loci in 40% (12/30) of these tumours [35% (9/26) at 11p13 and 31% (8/26) at 11p15]. Our data suggest that inactivation of one or more tumour suppressor genes on 11p are involved in the genesis of testicular cancer. In addition, identification of the parental origin of the allelic losses revealed a paternal loss in six patients and a maternal loss in one case. © 1993 Wiley-Liss, Inc.

A female patient is described with multiple papillary transitional cell tumours involving left renal pelvis, left ureter, bladder and urethra with metastases to uterine cervix, uterine cavity and left ovary with cyst formation. The surgical management and possible explanations of the pathogenesis are discussed.

Twenty children with pelvic rhabdomyosarcoma treated between 1976 and 1983 are reviewed. The survival rate was 55% (11/20), with a bladder salvage rate of 54.5% among survivors. Systemic chemotherapy combined with radiotherapy and/or surgery was most effective in producing cure.

Mortality from various urogenital diseases including the malignant neoplasms of the genito-urinary system and the breast in Finland in 1955-1973 was studied. Only minor changes were found in the total death rate of all these diseases between 1955 and 1973. However, the age-specific death rates of the nephritis-nephrosis group decreased both among males and females. Also mortality from all other urogenital diseases than malignant neoplasms decreased among elderly and middle-aged people. Mortality from malignant neoplasms of the breast increased slightly among elderly women and that of the prostate among elderly men. The autopsy rate of the deaths due to all other urogenital diseases (33.5% in 1973) than malignant neoplasms (27.4%) was of the same order as that recorded for all natural deaths (33.2%) in Finland between 1963 and 1973. Many types of malignant urogenital neoplasms remained significantly under-autopsied. The highest autopsy rates of the single urogenital diseases were recorded for acute nephritis and unqualified nephritis; the respective national rates were 90 and 71%, in 1973. These rates exceeded highly significantly the mean national autopsy rate of all deaths which was 38.2%.

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1. A study of 215 cases of metastatic pulmonary carcinoma revealed 34 (15.8 per cent) instances in which the histologic features were compatible with the diagnosis of primary bronchiolo-alveolar carcinoma. 2. The metastatic bronchiolo-alveolar tumors were found chiefly in cases of carcinoma of the pancreas, colon, breast, stomach, and kidney, respectively. 3. Bronchiolo-alveolar carcinoma is not a specific entity, but a histologic pattern of malignant epithelial proliferation occurring both in primary and metastatic lung cancer. 4. The distinctive glandular appearance is dependent on the anatomic structure of the lung parenchyma which provides an alveolar stroma along which the malignant cells can propagate. The histologic differentiation between primary and metastatic bronchiolo-alveolar carcinoma presents a diagnostic challenge in the absence of necropsy.

A series of 36 patients having cutaneous metastases, including 32 necropsied cases in necropsy series of approximately 2,300 cases of internal carcinoma derived from the Long Beach Veterans Administration Hospital. The lung was the primary site in 17 of the 36 cases, the gastro-intestinal tract in 8 and the genito-urinary tract in 10; the primary site of one was uncertain. The tumors of the lung most commonly metastasized to the skin of the chest and those of the gastro-intestinal tract and genitourinary tract to the abdominal wall. The skin metastases were multiple except for 4 cases, usually widespread in location and occasionally appeared in small crops. The tumors were most commonly solid painless elevated nodules, ranging from one to 3 cm in diameter, having an intact overlying epidermis. The microscopic appearance had features of adenocarcinoma in 26 of the 36 cases. The skin tumors were indicative of progression of the primary tumor and early fatal termination, the duration of life averaging about 3 months after the appearance of the skin tumors. The necropsies revealed widespread metastases.