요도에 발생한 편평상피세포암종을 동반한 대장형 용종

초록

Urethralcolonic type polyp is very rare and only several cases were reported. It presents as a urethral caruncle. However the histologic features revealed colonic type mucosal glands with focal regenerative atypia. The histogenesis of this lesion is unclear. Several hypotheses were suggested. One of them is metaplastic theory. The second is congenital in nature and the third theory is that its probable origin is an intraurethral cloacogenic colonic rest. We experienced a case of colonic type polyp associated with squamous cell carcinoma in the surface epithelium of the urethra. The lesion such as this case was not previously reported. The patient was 54-year-old female. She was suffered from fever and both flank pain for 10 days and urethral mass for 30 years. The resected specimen consisted of two masses showing gray brown, multinodular appearance, measuring 3.5x3.5x2.5cm of the larger one. The cut surface showed gray tan and myxoid. The microscopic finding showed scattered tubular glands similar to the colon. The tubular epithelium showed mild degree of dysplasia with stratified and hyperchromatic nuclei. The surface of the mass was covered with stratified squamous epithelium. Most part of this epithelium was replaced by the squamous cell carcinoma in situ with focal stromal invasion. The surgical resection margin was free of tumor. The malignant change of this surface epithelium is probably due to longstanding irritation and stimulation.