1.A case report of female primary enteric adenocarcinoma of the urethra:3 surgeries and 39-month follow-up
Peili MA ; Haitao DAI ; Zhong ZHANG ; Guanghai JI ; Meiyuan ZHOU ; Changwei PENG
Journal of Modern Urology 2025;30(9):784-787
Objective To explore the clinical characteristics and treatment methods of female primary enteric adenocarcinoma of the urethra.Methods The diagnosis and treatment of one case were reported.The origin,etiology,imaging findings,diagnosis,treatment,and prognosis were discussed in combination with relevant literature.Results The patient is a 61-year-old female,visited our hospital due to vaginal odor complicated with urethral bleeding for 2 months,and was diagnosed with urethral adenocarcinoma after examination.She underwent partial urethral resection,urethral meatus shaping and temporary bladder fistula surgery,with negative resection margins.However,local recurrence occurred 7 months after surgery.The patient was readmitted for a second time,undergoing laparoscopic total urethral resection,anterior vaginal wall resection,bladder neck resection,and permanent bladder fistulation,followed by chemotherapy.At the 19th month after the first surgery,the patient was admitted due to tumor recurrence,and the third surgery consisted of total bladder and uterus resection,ileal neobladder,and perineal closure.Postoperative pathology indicated urethral adenocarcinoma originating from the intestines.During the 39-month follow-up,the tumor recurred twice.No recurrence or metastasis was observed after the final total pelvic exenteration.Conclusion Enteric adenocarcinoma of the urethra is extremely rare.Comprehensive treatment including surgery,radiotherapy,and chemotherapy may prolong survival,but the overall prognosis is poor,requiring long-term follow-up.
2.A case report of female primary enteric adenocarcinoma of the urethra:3 surgeries and 39-month follow-up
Peili MA ; Haitao DAI ; Zhong ZHANG ; Guanghai JI ; Meiyuan ZHOU ; Changwei PENG
Journal of Modern Urology 2025;30(9):784-787
Objective To explore the clinical characteristics and treatment methods of female primary enteric adenocarcinoma of the urethra.Methods The diagnosis and treatment of one case were reported.The origin,etiology,imaging findings,diagnosis,treatment,and prognosis were discussed in combination with relevant literature.Results The patient is a 61-year-old female,visited our hospital due to vaginal odor complicated with urethral bleeding for 2 months,and was diagnosed with urethral adenocarcinoma after examination.She underwent partial urethral resection,urethral meatus shaping and temporary bladder fistula surgery,with negative resection margins.However,local recurrence occurred 7 months after surgery.The patient was readmitted for a second time,undergoing laparoscopic total urethral resection,anterior vaginal wall resection,bladder neck resection,and permanent bladder fistulation,followed by chemotherapy.At the 19th month after the first surgery,the patient was admitted due to tumor recurrence,and the third surgery consisted of total bladder and uterus resection,ileal neobladder,and perineal closure.Postoperative pathology indicated urethral adenocarcinoma originating from the intestines.During the 39-month follow-up,the tumor recurred twice.No recurrence or metastasis was observed after the final total pelvic exenteration.Conclusion Enteric adenocarcinoma of the urethra is extremely rare.Comprehensive treatment including surgery,radiotherapy,and chemotherapy may prolong survival,but the overall prognosis is poor,requiring long-term follow-up.
3.The scanning effect of the injection flow rate of contrast medium on magnetic resonance image dynamic contrast-enhanced of prostate cancer
Jun ZHANG ; Xuemei YIN ; Guanghai JI ; Lei CAI ; Peng LI ; Zhiqiang CHEN
The Journal of Practical Medicine 2015;31(15):2466-2470
Objective To investigate the effect of perfusion index of the injection flow rate of contrast medium on magnetic resonance image dynamic contrast-enhanced (DCE-MRI) of prostate cancer with different pathological grades. Methods Seventy patients with PCa、cardiac, normal renal function is and BMI≤25 kg/m2 were enrolled. The 2.5 mL/s, 5.0 mL/s dynamic enhanced injection velocity contrast agent was used for 35 patients and the reast 35 patients, respectively. All data was transferred to GE Advanced Workstation 4.3, and the indexes of the peripheral prostate cancerous zone were calculated by Functool2 of signal intensity time (SI-T), The time to minimum (Tmax), the whole enhancement degree (SImax%) and the maximum slope (Rmax) were calculated. The effect of different injection velocity on the dynamic enhanced perfusion index was analyzed. Results Tmax of pa-tients received 2.5 mL/s, 5.0 mL/s contrast agent injection velocity in the low risk group (Gleason score 2 to 6)、medium risk group (7 Gleason score) and high risk group (Gleason score 8 to 10) were (19.89 ± 2.76) s and (15.42 ± 1.68) s, (16.91 ± 2.34) s and (12.88 ± 1.73) s, (14.13 ± 1.81) s and (10.2 ± 1.42) s, with signifi-cant differences (t = 4.61, 3.1, 3.25, P < 0.01). The average SImax% of PCa in the two groups were (1.45 ± 0.17)%and (1.51 ± 0.27)%, (1.62 ± 0.12)%and (1.84 ± 0.18)%, (1.86 ± 0.16)% and (2.11 ± 0.28)%, Two groups of SImax% were statistically significant difference (t = -2.44, -4.55, -5.16, P < 0.05), respectively. The average Rmax of PCa of the two groups were (6.29 ± 2.62)% and (7.64 ± 4.09)%,(8.92 ± 4.21)% and (10.24 ± 9.09)%, (10.85 ± 2.89)% and (12.43 ± 3.51)%, with significant difference (t = -4.07,-3.85, -8.68, P <0.01). Tmax was shorter, SImax% and Rmax were higher of prostate cancer patients received 5.0 mL/s contrast agent injection velocity than those received 2.5 mL/s contrast agent injection velocity. Conclusion The dynamic enhancement perfusion index of prostate cancer patients received 5.0 mL/s contrast agent injection velocity is more sensitive than that of patients received 2.5 mL/s contrast agent injection velocity , which can improve the diagnosis of prostate cancer.

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