Pathology and natural history of urethral tumors in males. Review of 142 cases.
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Biomedical subjects
Publications and source records attributed to M M Melicow.
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A discussion of the term urothelium and reasons for its general adoption are presented. The unique asymmetric unit membrane of the superficial cells is described and its function as a significant barrier against water, some electrolytes and so forth is reviewed. The urothelium bears the brunt of the attack by pollutants and various oncogens. The ongoing battle may be of long duration or recurrent. Many factors enter into the development of a tumor. In addition to actual carcinogens there are irritants, promoters, initiators, weak carcinogens and co-carcinogens. The attack is on the asymmetric unit membrane and the Golgi complex or other coding units. The specialized membrane is destroyed and, instead, a thinner, smooth, flexible membrane develops and overlying it a filamentous glycocalix. The mechanism for specialization by the urothelial cell has been destroyed by the oncogen. Cancer does not occur in unicellular organisms. The cells of all multicellular organisms specialize. The first step toward neoplasia in multicellular organisms is the destruction of specialized mechanisms or coding units of a group of specialized cells, the second step is stimulation by governors and the third is inadequate blood supply. The ultimate in the cancer cell of a multicellular organism, anaplasia, is the return to the unicellular stage.
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Cancer of the female urethra, although uncommon, is important because unless recognized early and treated adequately, death will ensue, preceded by much morbidity. The authors present a series of 62 patients with 70 primary tumors, and 3 patients with secondary tumors. A comprehensive classification of neoplasms of the female urethra is also included.
Conceptually, the prostatic territory encompasses neoplams whose origins are intraprostatic, paraprostatic or extraprostatic. Our objectives in this review are to 1) present a classification of the spectrum of malignant epithelial growth encountered in the prostatic territory, 2) show examples of these neoplasms and remark upon their histogenesis, enzyme production and endocrine sensitivity, and 3) suggest re-evaluation of some of our current routine therapeutic procedures.
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Two cases of double primary prostatic adenocarcinoma are described. A periurethral papillary adenocarcinoma coexisted with the common acinar type of cancer, which tends to arise deep in the corpus of the gland. We are of the opinion that the patterns observed in these tumors are not mere variations of one neoplasm, but rather two dissimilar growths of diverse cell origin, varried histology, and possibly also of disparate biologic potential.
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