Nodular or red hemorrhagic mass in the urethra

Introduction Early symptoms of paraurethral adenocarcinoma are dysuria, urethral bleeding, frequent urination, and dysuria. A nodular or red hemorrhagic mass appears in the distal urethra or urethra, and local swelling of the urethra can reach the mass. When the tumor is enlarged, it can block the urethra or expand into the vestibular vestibule and vaginal opening, and there are obvious ulcers and hemorrhagic masses, accompanied by pain and possible metastasis of the groin and pelvic lymph nodes.

Cause

The etiology of paraurethral adenocarcinoma is not very clear. Some scholars believe that urinary tract irritation may be a cause of urinary tract cancer caused by urination, sexual intercourse, pregnancy or repeated urinary tract infection. Proliferative diseases such as meat mites, papillomas, adenomas, and polyps are secondary to malignant transformation. Urethral leukoplakia is considered a precancerous lesion.

an examination

Related inspection

Urethral secretion examination urine routine

Diagnosis: Adenocarcinoma of the urethra can be initially diagnosed according to the symptoms and signs of clinical manifestations; it can be diagnosed when the urethral mass biopsy is adenocarcinoma. The time from symptom onset to diagnosis may be several days, or may be several years, usually 3 to 12 months. In a few cases, patients may have no symptoms. They often find urinary tract cancer by accident to check other diseases. .

Middle and lower urethral cancer may be discovered by visual inspection or palpation examination. The lesion may be bright red papillary sputum to the urethral cavity and urethral orifice. At this time, it is easy to be misdiagnosed as urethral meat emulsion, and the misdiagnosis rate is about 8%. New urethra should also be differentiated from urethral mucosal prolapse and diverticulum caused by acute and chronic inflammation. Urethral cancer can be found through vaginal palpation, vaginal examination can touch the urethra thickening, hardening and cord-like mass. Vaginal examination can understand the size, texture, activity, etc. of the lesion, vaginal double examination to understand whether there is bladder and pelvic metastasis. When the lesion invades the vaginal wall, it is difficult to determine whether the primary lesion is from the urethra or from the vagina itself.

Bladder urethroscopic examination and biopsy are the main methods for diagnosing urinary tract cancer. Some lesions hardly grow into the urethra. Bladder urethroscopic examination may miss the diagnosis. At this time, the lesion can be moved to the urethra by fingers with the fingers of the vagina, which will better expose and observe the lesion. Diagnosis of urethral cancer requires a biopsy pathological diagnosis. The biopsy is best taken from the urethra. In a few cases, the material can be drawn through the vaginal needle. You can take morning urine or use a urethral swab or a spatula to reach the urethra to take exfoliated cells for cytological examination. After the diagnosis, further comprehensive examination is needed to understand the extent of the lesion, to exclude cancer metastasis, and to define the clinical stage.

Laboratory tests: urine routine examination, secretion examination, tumor marker examination, polymerase chain reaction detection.

Other auxiliary examinations: histopathological examination.

Differential diagnosis

1. Early paraurethral adenocarcinoma should be distinguished from urethral meat emulsion. For urethral meat fistula with suspected malignant transformation, biopsy should be performed to confirm the diagnosis.

2. Middle and advanced paraurethral adenocarcinoma should exclude whether the primary lesion is from the vestibule, but the former is adenocarcinoma and the latter is squamous cell carcinoma.

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