Malakoplakia of the Genitourinary Tract: A Report of 3 Cases

Abstract

KEYWORDS: Malakoplakia; Michaelis-Gutmann bodies; Urethral tumor; UrethralMalakoplakia is a rare chronic inflammatory disease, most commonly found in the urinary tract. It has been associated with chronic infections, malignancies, and immunocompromised states. The authors present 3 cases of malakoplakia of the genitourinary tract, seen in 3 female patients who sought medical attention due to pain or bleeding. The histopathological examination in all cases was compatible with malakoplakia and characterized by the presence of Michaelis-Gutmann bodies. All patients were effectively treated with surgical excision in combination with antibiotic therapy.

Vaginal Malakoplakia

“…Bhaijee et al 10 reported that prolonged cotrimoxazole therapy resolved mass caused by malakoplakia. No recurrence was detected during a 3-year follow-up 4,10,35,36 …”

“…No recurrence was detected during a 3-year follow-up. 4,10,35,36 Appropriate workup of suspicious masses consists of imaging to determine the extent of the mass, biopsy to rule out malignancy, histopathological review for the presence of Michaelis-Gutmann bodies, and age-appropriate cancer screening. 1,14,16 Several organisms are hypothesized to play a role in the pathogenesis of malakoplakia, including E. coli, Mycobacterium tuberculosis, Proteus, and S. aureus.…”

“…39 Antibiotics also serve to manage recurrent UTIs, which have been observed in chronic cases of pelvic malakoplakia. 36,40 Additional medications, like anticholingeric agents and ascorbic acid, can also be used to combat malakoplakia. Anticholinergic agents, like bethanechol, increase cGMP, whereas ascorbic acid decreases cAMP, thereby facilitating intracellular bacterial digestion by macrophages.…”

Angiomyxoma Presenting as an Unusual Vaginal Mass

“…Treatment options include use of hormonal manipulation, such as tamoxifen, raloxifen or GnRH analogs, radiotherapy and arterial embolisation. 6 .…”

“…When a female patient come with such symptom a detailed history and examination is necessary. A simple pelvic examination may reveal the cause ofdysuria in some case.Physical examination including specular examination of the vagina and urethra may reveal causes of dysuria that are not related to urinary tract infections 6 .…”