Department of Pathology, Amasya University, School of Medicine, AMASYA, TURKEY.
Turk Patoloji Derg. 2021;37(2):161-166. doi: 10.5146/tjpath.2020.01502.
Villous adenomas (VAs) in the female urethra are rare with only seven cases in the English literature to our knowledge. In patients with bladder augmentation cystoplasty, the neoplasia development risk increases and most of these develop in the neobladder or anastomosis line. Only two cases of VA developing from the native bladder mucosa have been reported. Physical examination of a 76-year-old female who had a history of augmentation cystoplasty revealed a caruncula-like structure protruding from the urethral meatus. The urinary USG showed that the lesion had no relation with the bladder. The lesion was excised. Microscopically, it consisted of villous structures covered with pseudostratified intestinal type epithelium. Low-grade dysplasia was present in the epithelium but high-grade dysplasia or in-situ/invasive carcinoma was not observed. Immunohistochemical study showed positivity for CK7, CK20, EMA, CEA and CDX2. The case was reported as VA of the urethra. We presented the first VA case arising in the urethra of a female patient with intestinal bladder augmentation. Excision is curative for pure VAs. Transformation to carcinoma or recurrence has not been reported. However, in one third of the cases, a malignant tumor may accompany the lesion. Therefore, all excision material should be examined carefully. Routine endoscopic follow-up should be performed in cases with bladder augmentation.
女性尿道绒毛状腺瘤（VA）罕见，据我们所知，英文文献中仅有 7 例。在接受膀胱扩大成形术的患者中，肿瘤发生的风险增加，而且大多数肿瘤发生在新膀胱或吻合线处。仅有 2 例报告源自固有膀胱黏膜的 VA。对一名 76 岁女性进行体格检查，该女性曾有过膀胱扩大成形术病史，发现尿道口有一个类似肉阜的结构突出。尿路超声检查显示病变与膀胱无关。切除了病变。显微镜下，它由绒毛状结构组成，覆盖有假复层肠型上皮。上皮存在低级别异型增生，但未观察到高级别异型增生或原位/浸润性癌。免疫组织化学研究显示 CK7、CK20、EMA、CEA 和 CDX2 阳性。该病例报告为尿道 VA。我们报告了首例发生在女性肠膀胱扩大患者尿道的 VA 病例。单纯性 VA 行切除术可治愈。尚未报道转化为癌或复发。然而，三分之一的病例中，病变可能伴有恶性肿瘤。因此，所有切除的组织都应仔细检查。对接受膀胱扩大术的患者应进行常规内镜随访。
