Skene's gland.

[pjoshea13]

New German paper below [5].

Skene's gland is the female prostate. (Yes, it does exist.) Although fPCa is rare, it has been reported.

The first case on PubMed was in Slovakia (1993) [1].

"An autopsy case of adenocarcinoma of Skene's paraurethral gland co-incident with renal cell carcinoma is described. The adenocarcinoma showed distinct prostate specific antigen and prostate specific acid phosphatase pointing to the equivalence between the male prostate and Skene's paraurethral glands and ducts. Skene's gland are the homologue of the prostate in females and tumours arising from them are immunohistochemically similar to male prostate carcinoma."

[2] (1994 - U.S.)

"Skene's (periurethral) gland carcinoma is a rare neoplasm accounting for less than 0.003% of all genital tract malignancies in females. Generally, adenocarcinomas of the female urethra are assumed to arise from the periurethral glands, the female homologue of the prostate. A case of Skene's gland adenocarcinoma without mucosal urethral involvement is presented. The histologic features of this tumor closely resembled those of prostatic adenocarcinoma." "Preoperatively, the serum level of PSA was increased and promptly decreased after surgical excision of the lesion."

[3] (2004 - U.S.)

"An 88-year-old woman presented with gross hematuria and a 3-cm periurethral mass. Biopsy revealed an adenocarcinoma resembling prostatic adenocarcinoma; the tumor cells were positive for keratin and prostate-specific antigen. The serum level of prostate-specific antigen was elevated; the carcinoembryonic antigen and CA-125 serum levels were normal. One year after external beam radiotherapy, the patient is without evidence of disease. This is the sixth case of a urethral prostatic-type adenocarcinoma, tumors that are most likely of Skene's gland origin."

[4] (2012 - U.S.)

"A 71-year-old patient was evaluated for a 2 year history of painless hematuria and found to have a localized Skene's gland adenocarcinoma resembling prostate adenocarcinoma with a pre-therapy PSA of 54.52 ng/ul. She elected to undergo definitive radiotherapy holding radical surgery for salvage." "The PSA decreased to 0.65 ng/ul 32 months after treatment, her clinical symptoms resolved"

...

New paper: "We present a case of a female patient who had a clinically suspected advanced urothelial carcinoma of the urethra. Histopathological examination surprisingly revealed a malignant tumor with morphological and immunohistochemical features of prostate cancer, leading to the diagnosis of the extremely rare entity of Skene's gland adenocarcinoma."

...

Someone is bound to ask the question why, if Skene's gland is really similar to the prostate, is fPCa so rare? I look forward to the theories.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/750...

[2] ncbi.nlm.nih.gov/pubmed/752...

[3] ncbi.nlm.nih.gov/pubmed/146...

[4] ncbi.nlm.nih.gov/pubmed/208...

[5] ncbi.nlm.nih.gov/pubmed/287...

[Wassersug]

Patrick,

Good to see you posting here as evidence that your PCa treatments are working. How are you doing?

As for your question, "why, if [the] Skene's gland is really similar to the prostate, is fPCa so rare?", the most likely answer is low T. My colleague and I have in press a summary of the data on prostate cancer in male to female (MtF) transsexuals, who go off of T. The incidence is extremely low.

I suspect conversely that with the current popular interest in early transitioning for FtMs--who go on high dose T as adolescents--whether the incidence of fCPa (as you label it), will go up. I also wonder if the endocrinologists, who treat these transgender youths, advise them of this possibility.

Richard W.

[pjoshea13 in reply to Wassersug]

Hi Richard,

I thought you might respond. I am doing well & I hope you are too, on your estradiol regimen.

It's tempting to look at the question in terms of testosterone [T] &/or estradiol [E2] levels, or even my favorite E2:T ratio, but "la différence" might be a lot more complicated, I suppose.

Young men with high T don't get PCa, and PCa tends to emerge at an age when we have lost about a third of our youthful T.

& PCa cases tend to have lower T than matched controls. & those with the lowest T have a poorer prognosis.

Patrick Walsh has reported the T rises in the year following RP, & suggested that the cancer somehow lowers T. Which indicates to me that T supplementation in new cases might sometimes be beneficial.

...

It's an interesting question, I feel, in that the risk of fPCa is extraordinarily low, & the risk for a man who has died of "old age" having undiagnosed PCa is extraordinarily high.

I was rather hoping you would attribute female protection to high E2 rather than low T, but perhaps the menopause messes that idea up.

There was a recent paper on MtFT PCa:

"The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?"

ncbi.nlm.nih.gov/pubmed/281...

Best, -Patrick

[kittik9]

I have a skene's gland cyst and you are pretty literally the only person that has posted anything about it on this site.

Do you have not medical jargon to make me feel better and that it isn't cancer?

Thanks.

-K

[pjoshea13 in reply to kittik9]

Hi K,

The latest paper on the subject is from 2018 [1]:

"Skene's (periurethral) gland adenocarcinoma is very rare, with only 7 cases reported in the literature. "

& so, I'd say that it is very unlikely that you have cancer.

The paper reports on the 4 cases seen at Johns Hopkins.

"All patients were alive and free of recurrence or metastatic disease at the time of last follow-up."

A paper from 2000 leads me to think that you need a PSA [prostate-specific antigen] test to put your mind at rest. [2]

I'd love to be a fly on the wall when you ask your doctor for the test!

Best, -Patrick

[1] pubmed.ncbi.nlm.nih.gov/299...

[2] pubmed.ncbi.nlm.nih.gov/106...