PMC6590554_01
Abdominal enhanced computed tomography images showing a 3.0x5.0 cm mass with a heterogeneous contrasting effect between the urethra and bladder neck. (a) Sagittal section (arrow indicates tumor). (b) Coronal section (arrow indicates tumor).
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Enhance computed tomography revealed a 3.0x5.0-cm mass with a heterogeneous contrasting effect between the urethra and bladder neck (Figure 1), though no distant metastasis was found.
Macroscopic view of excised specimen. On the left is the full specimen and on the right is an enlarged image showing the tumor. The excised specimen had two ulcerated cancer lesions, one (3.0x1.8 mm in diameter, dotted arrow) around the trigon of the urinary bladder and the other (2.5x3.0 mm in diameter, arrow) on the proximal urethra.
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As shown in Figure 2, the excised specimen contained two ulcerated cancer lesions, one around the trigon of the urinary bladder and the other on the proximal urethra.
Histopathological findings. The diagnosis was urethral adenocarcinoma with various characteristics. (a) Hematoxylin and eosin stain, x40. (b) Hematoxylin and eosin stain, x200.
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Pathological assessment of the resected specimen revealed a poorly differentiated adenocarcinoma with various characteristics, such as clear cytoplasm and an NE tumor appearance (Figure 3).
Immunohistochemical findings. (a) Tumor cells strongly positive stained for AFP (x200). (b) Positive staining for CD56 (x200). (c, d) Several cells were immunohistochemically positive for (c) chromogranin A (x200, arrowheads) and (d) synaptophysin (x200, arrowheads).
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Immunohistochemistry was performed, which showed cells stained positive for AFP (Figure 4(a)), and negative for CEA, CA19-9, PSA, and p63. A (Figure 4(c)), and synaptophysin (Figure 4(d)). As these characteristics of the tumors were common to the two lesions, we considered that they were originally continuous lesion before transurethral resection.