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女性原发性尿道癌少见,发病率占女性恶性肿瘤的0.02％,我院1968年以来收治4例,现报告如下。临床及病理资料4例年龄为40岁～68岁,平均54岁,均为已婚经产农妇。病程:8个月～1年2例,3～5年2例。症状:主要为尿频、尿疼及排尿困难。其中1例发生急性尿潴留,1倒排出脓血性分泌物,术前诊断均为尿道癌,其中2例发病初期分别在外院诊断为尿道“息肉”,1例当时切除未活检,不久复发;1例未予切除,病变均继续发展至排尿困难而转入本院。治疗:均行全尿道切除。其中同时行膀胱与直肠吻合术者1例,耻骨上膀胱造瘘及腹股沟淋巴结清扫术1例。术后3例放疗,1例化疗。病理检查见肿瘤均为蕈状型,小者2×2×1cm,大者3.5 ×3×2cm,3例累及前尿道,1例累及全尿道并腹股为淋巴结转移。镜检:鳞状细胞癌2例,乳头状移行细胞癌1例,腺癌1例。术后结果:鳞癌1例生存5年2个月,1例术后2年失访,其余2例生存期均未超过1年6个月。
Female primary urinary tract cancer is rare, and the incidence rate is 0.02% of female malignant tumors. Four cases have been treated in our hospital since 1968. The current report is as follows. Clinical and pathological data of 4 cases aged 40 to 68 years old, average 54 years old, are married farmers. Duration: 8 months to 1 year in 2 cases, 3 to 5 years in 2 cases. Symptoms: mainly urinary frequency, urinary pain, and difficulty urinating. One patient developed acute urinary retention and discharged pus and bloody discharge. Preoperative diagnosis was urinary tract cancer. Two cases of urethral polyps were diagnosed in the outpatient department in the early stage of the disease. One case was not biopsied at the time and relapsed soon. Cases were not resected, and the lesions continued to progress to dysuria and were transferred to the hospital. Treatment: All urethral resections were performed. Among them, one patient underwent both bladder and rectal anastomosis, one case of suprapubic bladder fistula and inguinal lymph node dissection. After 3 cases of radiotherapy, 1 case of chemotherapy. Pathological examination showed that all tumors were verrucous type, the small 2 × 2 × 1cm, the larger 3.5 × 3 × 2cm, 3 cases involving the anterior urethra, 1 case involved the urethra and abdominal femoral lymph node metastasis. Microscopic examination revealed 2 cases of squamous cell carcinoma, 1 case of papillary transitional cell carcinoma, and 1 case of adenocarcinoma. Postoperative results: One case of squamous cell carcinoma survived for 5 years and 2 months, 1 case was lost to follow-up at 2 years, and the remaining 2 cases did not surpass 1 year and 6 months.