Hematospermia and Cloacogenic Transitional Cell Carcinoma: A Twist on Significance and Meaning

A 52-year-old gentleman presented with recurrent hematospermia. Further history revealed recent onset of constipation and difficulty voiding. Rectal examination revealed a firm, polypoid mass and colonoscopy showed suspicious, ulcerated lesions of the rectal mucosa with narrowing of the rectal vault. Pathology demonstrated transitional cell carcinoma of the rectum. While transitional cell carcinoma is a common genitourinary cancer, its presence in the anus and rectum is exceedingly rare. Furthermore, hematospermia is generally not associated with malignancy. This case is a remarkable example of two pathologic processes presenting in rare form and underscores the value of a thorough investigation of hematospermia when associated with other clinical symptoms

Urethral duct invasion in female urethral melanoma

Primary melanoma of the genitourinary tract represents ≤1% of all melanomas and is a highly aggressive malignancy, usually presenting at an advanced stage. Primary urethral melanomas are often amelanotic, leading to difficulties in early clinical diagnosis and biopsy delays. Herein, we present the clinical follow-up and histopathology of two female patients with microscopic invasion of the urethral ducts, not illustrated by previous reports. This finding, verified by appropriate immunohistochemical markers, can be a useful clue in diagnosing amelanotic melanoma of the genitourinary tract. The pathology reporting for urethral melanoma should include the depth of invasion, mitotic index, the status of resection margins, perineural invasion and lymphatic invasion since they will likely have a bearing on the tumor's biological behavior. Herein, we report two female patients with urethral melanoma exhibiting urethral duct invasion. Moreover, we discuss pertinent histopathological and immunohistochemical features, along with oncogene mutational typing that may aid in confirming the diagnosis and identifying molecular target(s)