Urethral hemangioma with carcinoma in situ: a case report.

BACKGROUND

Urethral hemangioma is an exceptionally rare benign vascular tumor, with scarce data available on its natural history and therapeutic strategies. The coexistence of carcinoma in situ within urethral hemangioma has not been previously documented in medical literature.

CASE PRESENTATION

A 62-year-old woman presented with a protruding mass at the external urethral orifice. The lesion was completely excised by surgical resection. Histopathological analysis revealed squamous cell carcinoma in situ (SC-CIS) within the urethral hemangioma. The patient refused to undergo repeat surgical treatment again for SC-CIS due to surgical complications. The patient received adjuvant radiotherapy (total dose 50 Gy/25 fractions) following pathological confirmation of involved surgical margins. Long-term follow-up, including annual CT scans and cystoscopies, showed no evidence of disease recurrence at 7 years post-treatment.

CONCLUSION

Few cases of urethral hemangioma have been documented in the literature, and no previous reports have descried urethral hemangiomas coexisting with SC-CIS. Surgical treatment emphasizes the complete resection of the lesions. When margin involvement by malignant cells was identified, adjuvant radiotherapy is an essential component of the combined-modality approach. The 7-year recurrence-free survival in this case suggests that this combined-modality approach provides durable local control.