Dodson M K, Cliby W A, Pettavel P P, Keeney G L, Podratz K C
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Gynecol Oncol. 1995 Dec;59(3):352-7. doi: 10.1006/gyno.1995.9963.
Adenocarcinoma of the female urethra accounts for 10% of all urethral cancers. Controversy continues to exist over the origin of primary urethral adenocarcinomas. The periurethral (Skene's) glands appear to be the homologues of the male prostate as defined by authors evaluating cadaver-derived periurethral glands pathologically and immunohistochemically (prostate-specific antigen (PSA)). It is traditionally assumed that the origin of female urethral adenocarcinoma is the Skene's gland. However, no one has evaluated a series of primary urethral adenocarcinomas in an effort to scrutinize this assumption. We, therefore, evaluated 13 primary adenocarcinomas of the female urethra comparing histologic and immunohistochemical characteristics. Tumors were classified into two major histologic groups: columnar/mucinous (11) and clear cell (2). Excluding one case, the columnar/mucinous tumors resembled either endometrial or colonic adenocarcinoma. The exception was a case bearing a striking resemblance to prostatic adenocarcinoma. Immunohistochemical results revealed positive PSA staining for this tumor alone. The patient's preoperative serum PSA was elevated, but rapidly declined postoperatively. Based on immunohistochemical findings and the presence of distinct histologic subtypes (columnar/mucinous, clear cell), it appears that female urethral adenocarcinoma has more than one tissue of origin with a minority arising from the Skene's glands.
女性尿道腺癌占所有尿道癌的10%。原发性尿道腺癌的起源一直存在争议。经病理和免疫组化（前列腺特异性抗原（PSA））评估尸体来源的尿道周围（斯基恩氏）腺的作者认为，尿道周围腺似乎是男性前列腺的同源物。传统上认为女性尿道腺癌起源于斯基恩氏腺。然而，没有人对一系列原发性尿道腺癌进行评估以审视这一假设。因此，我们评估了13例女性尿道原发性腺癌，比较了其组织学和免疫组化特征。肿瘤分为两个主要组织学组：柱状/黏液性（11例）和透明细胞（2例）。除1例病例外，柱状/黏液性肿瘤类似于子宫内膜腺癌或结肠腺癌。例外的是1例与前列腺腺癌极为相似的病例。免疫组化结果显示仅该肿瘤PSA染色呈阳性。患者术前血清PSA升高，但术后迅速下降。基于免疫组化结果和不同组织学亚型（柱状/黏液性、透明细胞）的存在，女性尿道腺癌似乎有不止一种组织起源，少数起源于斯基恩氏腺。
