Microsoft Word - GOI069BF

Adenocarcinoma Urethral diverticulum Vaginal cancer Abstract We report an extremely rare case of a 50-year-old woman with an adenocarcinoma arising within a urethral diverticulum. She could not be diagnosed correctly before operation and the microscopic pathological examination of the surgical specimen was the only indication showing the cancer origin. Yasuhiko Nakamura, MD, Department of Obstetrics and Gynecology, Yamaguchi University School of Medicine, 1144 Kogushi, Ube 755 (Japan) Introduction Urethral diverticula are not uncommon, with incidence rates of 1-6% [1], and are generally caused by recurrent infections or trauma to the paraurethral glands. However, a carcinoma arising within a urethral diverticulum is extremely rare. The first case was documented in 1951 by Hamilton and Leach, and there are 68 cases in the literature to date [2]. Described here is a case of adenocarcinoma arising within a urethral diverticulum which could not be diagnosed correctly before operation. Case Report A 50-year-old woman, gravida 2, para 2, visited a urologist because of urinary incontinence 2 months ago. Since urethral endos-copy and the urine examination pointed out no malignancy in her urinary tract, she was referred to a gynecologist. She was pointed out to have a tumor in the anterior vaginal wall and received a punch biopsy which revealed a vaginal adenocarcinoma. Then, she was referred to our hospital. Since primary adenocarcinoma in the anterior vaginal wall is very rare [3], she was instructed to have the following examinations: cervical Papanicolaou’s smear test, gastrointestinal tract screening, urinary tract screening, breast screening, chest X-ray, computed tomography, magnetic resonance imaging (MRI) and abdominal ultrasonography. Urethral endoscopy showed no abnormal urethral lesion and no abnormal cell was detected in her urine by cytological examination. There was also no abnormal finding in the uterus, the gastrointestinal tract, the breast and the lung. The MRI showed that the tumor was 3.5 × 1.0 × 1.0 cm in size and located between the urethra and