Raison Nicholas, McGovern Ursula, Hines John, Volanis Dimitrios
Department of Urology, Royal Free London NHS Foundation Trust, London, UK.
Division of Transplantation Immunology and Mucosal Biology, King's College London, London, UK.
BMJ Case Rep. 2019 Mar 21;12(3):e227948. doi: 10.1136/bcr-2018-227948.
Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour found predominantly in the gastrointestinal tract. Comprising adenocarcinomatous and neuroendocrine components, MANEC have been reported in the bladder. We report the first case to our knowledge of a MANEC arising in the urethra. A 62-year-old woman presented with a suburethral mass. Initial excision of the mass revealed it to be a MANEC. Immunohistochemistry staining was positive for CK20 and synaptophysin associated with neuroendocrine tumours. Cross-sectional imaging ruled out metastases and the patient underwent radical urethrectomy, vaginal reconstruction and Mitrofanoff urinary diversion. The patient declined adjuvant chemotherapy and remained under regular surveillance. MANECs are uncommon tumours and treatment was therefore guided by expert opinion. A multidisciplinary approach is essential with the early involvement of surgeons, oncologists, histopathologist, radiologist and neuroendocrine specialists.
混合性腺神经内分泌癌（MANEC）是一种罕见肿瘤，主要见于胃肠道。MANEC由腺癌和神经内分泌成分组成，膀胱中也曾有过相关报道。据我们所知，我们报告了首例发生于尿道的MANEC。一名62岁女性因尿道下肿物就诊。肿物的初步切除显示为MANEC。免疫组化染色显示细胞角蛋白20（CK20）和与神经内分泌肿瘤相关的突触素呈阳性。横断面成像排除了转移，患者接受了根治性尿道切除术、阴道重建和米氏可控膀胱术。患者拒绝辅助化疗，目前仍在定期监测中。MANEC是罕见肿瘤，因此治疗以专家意见为指导。多学科方法至关重要，外科医生、肿瘤学家、组织病理学家、放射科医生和神经内分泌专家应尽早参与。
