BERKELEY, CA (UroToday.com) - Chronic inflammation is a well-known risk factor for non-melanomatous skin cancer. Nicoli, et al.[1] reported a rare occurrence of squamous cell carcinoma (SCC) few weeks post CO2 laser application to a scar. Olaofe, et al.[2] reported the possible development of SCC in old surgical scars.
Urethral stricture is a commonly encountered problem in adult age groups, especially in developing countries. Some clinicians, especially with compliant patients, tend to do endoscopic visual urethrotomy, followed by regular urethral dilation, with successful control for the patients' urinary symptoms.
The urethra is a very precious channel that should be dealt with gently and wisely. Our published case was 55-year-old man who was managed repeatedly with both visual urethrotomies and urethral dilation. A decision to do urethral exteriorization was the factor resulting in the discovery of his tumor. Although this type of case is rarely encountered, I do not feel it is a strange occurrence. The case just followed the logical progression of chronic irritation and scarring as a predisposing factor for cancer. A few weeks after the publication of this work, we had another case that was managed in the same manner, to exteriorization, then urethral obliteration necessitating perineal urethrostomy. One month later, a large tumor was found that included the perineal urethrostomy.
We should really rethink the use of multiple urethrotomies or regular urethral dilation for our patients with urethral stricture. SCC on top of badly managed urethral stricture may not be so much rare, as underdiagnosed.
References:
- Nicoli F, Balzani A, Gentile P, et al. Squamous Cell Carcinoma Developing after CO2 Laser Resurfacing. J Cutan Med Surg. 2013 Mar-Apr; 17(2):139-42.
- Olaofe OO, Omoniyi-Esan GO, et al. Pseudoangiosarcomatous squamous cell carcinoma in an old surgical scar of an African woman. Afr J Med Med Sci. 2012 Sep; 41(3):317-20.
Written by:
Ahmed Fouad Kotb, MD, FEBU as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Urology department, Faculty of Medicine, Alexandria University, Al Khartom Square, Azarita, Alexandria, Egypt
Squamous cell carcinoma on top of urethral stricture: Case report and review of the literature - Abstract
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