郭謹瑋、嚴孟意

彰化基督教醫院 外科部 泌尿科

Chin-Wei Kuo, Meng-Yi Yan

Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

 

Primary urethral squamous cell carcinoma is a relative rare case that accounting for less than 1% of all cancers. Due to this reason, there are much lesser related article about how to management these kind of patient. We share one case that had primary squamous cell carcinoma of urethra and treated with radical penectomy accompanied with Chemoradiotherapy.

A 48 years old male, who was presented as fever accompanied with fever and peri-scrotal abscess formation. The physical examination revealed hard mass lesion over penile base with elastic glans penis. Urethral rupture to ventral penis was also noted. The cystoscopy revealed tumor like lesion over bulbar urethra. MRI revealed penile cancer, T3N3M0. Radical penectomy was arranged which showed priamry squamous cell carcinoma over urethra with Corpus spongiosum, corpus cavernosum, and skin of ventral part direct invasion. After operation, we arrange chemotherapy with Cisplatin and 5-FU accompanied with radiotherapy. He was free from recurrence for about half year. However, elevated squamous cell carcinoma antigen was noted 8 months after operation, which may indicated disease progression.

Urethral squamous cell carcinoma is rare and usually associated with urethral stricture, diverticulum o urethritis. The diagnosis is usually delayed because of the non-specific symptoms. Bulbar urethral disease carries a worse prognosis. The Prognosis of urethral squamous cell carcinoma is bad. The 5-year survival is around 0-15%. Combined treatment with chemoradiotherapy and operation is considered as better way for disease control.

We presented a rare case who had urethral squamous cell carcinoma who was treated with radical surgery accompanied with chemoradiotherpay. However early recurrence within one year was still noted.