洪巨軒、陳國強

國泰醫療財團法人國泰綜合醫院 外科部 泌尿科

Chu-Hsuan Hung, Kuo-Chiang Chen

Divisions of Urology, Department of Surgery, Cathay general hospital, Taipei, Taiwan

 

Primary urethral cancer is a rare malignancy in women, and adenocarcinoma accounts a less proportion. Nevertheless, most of adenocarcinoma was clear cell type, intestinal type was more uncommon. The published data on this topic are limited.

We report a case of a 64 year-old woman presenting with gross hematuria. Physical examination revealed a cauliflower reddish mass, 1.4cm in size, at external urethral meatus. Cystoscopy revealed no abnormal condition. Urethral caruncle was suspected initially. Hematuria was improved after treatment at outpatient department. However, hematuria exacerbated one year later. After discussion with patient, urethral mass excision was performed successfully with transurethral resection. Pathology reported intestinal type adenocarcinoma. The tumor stalk margin is free. In immunochemical stains, the neoplastic cells are CDX2(+)/ GATA3(-)/ PAX8(-)/ β-catenin (-). The morphology and immunoprofiles could be an adenocarcinoma of urethra origin. However, the possibility of a metastatic adenocarcinoma of colon origin could not be completely excluded. Further colonoscopy revealed no organic lesion in whole colon. No further adjuvant therapy was performed. No local recurrence or no systemic metastasis was detected during the 12-months follow-up period and two times cystoscopy.