Pelin YILDIZ, Zuhal GUCİN, Fatma Cavide SÖNMEZ, Zeynep TOSUNER, Dilek Sema ARICI, Yavuz Şinasi ÖNOL

PERİÜRETRAL HEMANJİYOM - NADİR BİR VAKA

Hemanjiyomlar, nadir vasküler tümörler olup, genitoüriner sistemde nadiren bulunurlar. 45 yaşında üretral travma ve varikosel operasyonu olan hasta, hematüri ve işeme güçlüğü şikayeti ile üroloji kliniğimize başvurdu. Sistoskopisinde proksimal üretrada 3 cm’lik darlık izlendi ve üreteroplasti uygulandı. Mikroskopik olarak periüretral fibrovasküler doku, çizgili kasta fibrozis, damar duvarlarında kalınlaşma, birbiriyle anastomozlaşan yarıklar ve kavernöz hemanjiyomatöz yapılar oluşturan papiller alanlar izlendi. Vasküler duvarı döşeyen hücreler; primer olarak endotelyal hücrelerce eksprese edilen CD 31 ile immunreaktivite gösterirken, lenfatik epitelde eksprese edilen D2-40 ile immunreaktivite izlenmedi. Lezyonu ‘periüretral hemanjiyom’ olarak raporladık. Tedavi sonrasında hastada üretral kanama olmamış ve semptomsuz olarak hayatına devam etmektedir. Literatürde 20’nin üzerinde periüretral hemanjiyom olgusu bildirilmiştir. Biz de bu nadir görülen; hematüri, hematospermi ve obstrüktif semptomlara yol açabilen lezyonu paylaşmak istedik

Periurethral Hemangioma - a Rare Case

Hemangiomas are benign vascular tumors, rarely seen in the genitourinary tract. A 45-year old man, with a history of urethral trauma and varicosel surgery was admitted to urology department with hematuria and hard urination. Cystourethroscopy revealed 3 cm urethral stricture on the proximal urethra and urethroplasty was applied. Microscopically, periurethral fibrovascular tissue, fibrosis in striated muscle, thickening on the walls of vessels, anastomosing irregular splits and cavernous hemangiomatous forming papillary structures were revealed. Immunohistochemically the lining cells of vascular walls are CD 31 + -used primarily to demonstrate the presence of endothelial cells, D2-40 - -selectively expressed in lymphatic endothelium. We reported the lesion as ‘periurethral hemangioma’. After treatment the patient is symptom-free without any episodes of urethral bleeding. In literature only little more than 20 cases of periurethral hemangiomas have been reported. Here, we want to share this rare lesion, which can cause hematuria, hematospermia and obsructive symptoms

Keywords:

periurethral, hemangioma, genitourinary tract,

PDF

___

1. Jahn H, Nissen HM. Haemangioma of the urinary tract: Review of the literature. Br J Urol 1991;68:113-7.

2. Uchida K, Fukuta F, Ando M, Miyake M. Female urethral hemangioma. J Urol 2001;166:1008.

3. Parshada S, Yadava SP, Arorab B. Urethral Hemangioma: an unusual cause of hematuria Urol Int 2001;66:43-45.

4. Klein TW, Kaplan GW. Klippel- Tranaunay syndrome associated with urinary tract hemangiomas. J Urol 1975;114:596–600.

5. Saito S. Posterior urethral hemangioma: one of the unknown causes of hematuria and/or hematospermia. Urology 2008;71:168.e11-4.

6. Kumar DA, Viswaroop SB, Kandasami SV, Arul M, Kathamuthu P, John B Capillary hemangiomatous polyp in anterior urethra. Indian J Med Sci 2007;61:531–532.

7. Efthimiou I, Kavouras D, Vasilakis P, Katsanis S. Hemangioma of penile urethra—treatment with simple transurethral excision: A case report. Cases J 2009;2:6199.

8. Rohan VS, Hanji AM, Patel JJ, Tankshali RA. Female urethral hemangioma. Saudi J Kidney Dis Transpl 2008;19:647–648.

9. Alfonso DSG, Esther MMM, Aurelio GRM, et al. Urethral hemangioma: a case report. Rev Mex Urol 2013;73:50-53.