Urethral cancer managed with phallus preserving surgery: a case report.
MetadataShow full item record
JournalJournal of medical case reports
AbstractBackground: Primary urethral carcinoma (PUC) is rare and accounts for < 1% of all genito-urinary cancers. There is a male predominance of 3:1 and a peak incidence in the 7th and 8th decades. The aetiology of this cancer is similar to penile cancer, and the human papilloma virus (HPV) is thought to be an essential factor in tumorigenesis. Urethral cancer should be diagnosed and staged with a combination of tumour biopsy, MRI, and CT with treatment involving a multimodal approach. Contemporary management emphasises phallus-preserving surgery where feasible. Case presentation: Here, we describe a case of distal urethral carcinoma, which presented as a metastatic groin mass and identifying the primary lesion proved challenging. Diagnostic flexible cystoscopy identified a tiny lesion in the navicular fossa, which was biopsied and confirmed to be a squamous cell carcinoma. The patient then underwent phallus preserving surgery, including distal urethrectomy with bilateral inguinal lymph node dissections. The final stage was pT1N1M0, and adjuvant chemotherapy was started. The distal urethrectomy involved the surgical creation of a hypospadic meatus in the midshaft of the penis. Normal voiding and sexual function were preserved. Conclusions: Urethral cancer is a rare malignancy and clinicians should bear in mind that early diagnosis of this disease can be very difficult depending on the anatomical location of the tumour. Treatment currently favours penis-preserving surgery.
- Distal urethral carcinoma: Contemporary management with phallus preserving techniques.
- Authors: O'Kelly JA, Browne E, Murray P, Keane J, Daly P, Cullen IM
- Issue date: 2022 Oct
- Distal urethrectomy for localized penile squamous carcinoma in situ extending into the urethra: an updated series.
- Authors: Pedrosa JA, Amstutz SP, Bihrle R, Mellon MJ
- Issue date: 2014 Aug
- [Penis-preserving surgery in patients with primary penile urethral cancer].
- Authors: Maek M, Musch M, Arnold G, Kröpfl D
- Issue date: 2014 Dec
- Penile-preserving surgery for male distal urethral carcinoma.
- Authors: Smith Y, Hadway P, Ahmed S, Perry MJ, Corbishley CM, Watkin NA
- Issue date: 2007 Jul
- The treatment of primary urethral carcinoma--the dilemmas of a rare condition: experience with partial urethrectomy and adjuvant chemotherapy.
- Authors: Hakenberg OW, Franke HJ, Froehner M, Wirth MP
- Issue date: 2001 Feb