Urethra - Clear cell adenocarcinoma

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Urethra

Clear cell adenocarcinoma

Reviewers: Turki Al-Hussain, M.D. (see Reviewers page)
Revised: 28 June 2012, last major update June 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

General
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● Usually women, mean age 58
● Similar clinical presentation to other urethral carcinomas
● Thought to arise from surface urotheilal metaplasia, or Müllerian rests or Müllerianosis

Case reports
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● 82 year old woman with urethral mass (Case of Week #194)

Gross description
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● Often (56%) arises within a urethral diverticulum

Micro description
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● Similar to clear cell adenocarcinoma of female genital tract
● Tubulocystic, papillary, and diffuse patterns
● Hobnail and flattened cells with abundant clear cytoplasm
● Moderate to marked nuclear pleomorphism
● Frequent mitotic figures

Micro images
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Clear cell adenocarcinoma: H&E


Left: CK7; right: CD15


Ki-67 staining


p53 staining

Differential diagnosis
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● Nephrogenic adenoma: no marked nuclear pleomorphism, no mitotic figures, no infiltrative or solid growth pattern

Positive stains
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● PAX2, PAX8

Negative stains
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● PSA, PAP
● Secondary involvement from female genital tract should be excluded

Additional references
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● Mod Pathol 1996;9:513

End of Urethra > Clear cell adenocarcinoma

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