Darboe Omar, Ngowi Bartholomeo Nicholaus, Mwasakyalo Gideon, Mwakio Christine, Kamau Rosemary Wangari, S Bashir Adan, David Waithera, Irungu Paul Juma
Department of Urology Kilimanjaro Christian Medical Centre Moshi Tanzania.
Department of Oncology Kijabe Kijabe Kenya.
Clin Case Rep. 2025 Jul 30;13(8):e70716. doi: 10.1002/ccr3.70716. eCollection 2025 Aug.
Generally, urethral malignancies are uncommon urological tumors that are more frequent in women than in men. The etiology of female urethral adenocarcinoma is yet unknown. Recurrent UTIs and urethral diverticula are two common risk factors linked to it. Clinical presentations can differ and are not always specific. A complete history and physical examination are part of management; urethrocystoscopy with urethral biopsy is used for diagnosis; investigations such as magnetic resonance imaging or abdominal computed tomography scans are used for staging; and treatment options include monotherapy and multimodal therapy. A 53-year-old female who presented with a 9-month history of lower urinary tract symptoms characterized by a burning sensation when passing urine, increased urinary frequency, and a feeling of incomplete bladder emptying associated with a feeling of a vaginal mass. A fixed fungating mass at the external urethral orifice was seen. Pelvic magnetic resonance imaging reported a retropubic urethral mass with bilateral inguinal lymph nodes. She underwent urethrocystoscopy with multiple urethral biopsies taken, and the specimen was sent for histopathology, which confirmed a well-differentiated urethral adenocarcinoma with mucin production. She was treated with chemoradiotherapy as per multidisciplinary team (MDT) meeting recommendations. She developed symptoms of radiation proctitis, which were treated with argon plasma coagulation. She has since been on follow-up at our oncology clinic, and a subsequent positron emission tomography CT scan reported no tumor recurrence or metastasis. She is currently doing well with no recurrence of symptoms. Although female urethral adenocarcinoma is uncommon, it requires comprehensive investigation when it is suspected, particularly in women who have nonspecific or recurrent lower urinary tract symptoms. Management should involve a MDT approach where available. Depending on the disease's stage and location, treatment options may include surgery, nonsurgical options such as radiotherapy and chemotherapy, or a combination. Patients should be monitored for any signs of recurrence of the illness. A better prognosis is said to exist for distal urethral cancers that are localized.
一般来说，尿道恶性肿瘤是不常见的泌尿系统肿瘤，在女性中比男性更常见。女性尿道腺癌的病因尚不清楚。复发性尿路感染和尿道憩室是与之相关的两个常见危险因素。临床表现可能不同，且并不总是具有特异性。完整的病史和体格检查是诊疗的一部分；尿道膀胱镜检查及尿道活检用于诊断；磁共振成像或腹部计算机断层扫描等检查用于分期；治疗选择包括单一疗法和多模式疗法。一名53岁女性，有9个月的下尿路症状病史，表现为排尿时有烧灼感、尿频增加，以及膀胱排空不全感并伴有阴道肿物感。在外尿道口可见一个固定的蕈状肿物。盆腔磁共振成像报告耻骨后尿道肿物伴双侧腹股沟淋巴结肿大。她接受了尿道膀胱镜检查并进行了多次尿道活检，标本送去做组织病理学检查，结果证实为伴有黏液分泌的高分化尿道腺癌。根据多学科团队（MDT）会议建议，她接受了放化疗。她出现了放射性直肠炎症状，采用氩等离子体凝固术进行了治疗。此后她一直在我们的肿瘤诊所接受随访，随后的正电子发射断层扫描CT报告未发现肿瘤复发或转移。她目前情况良好，症状未复发。尽管女性尿道腺癌不常见，但当怀疑有该病时需要进行全面检查，尤其是对于有非特异性或复发性下尿路症状的女性。如有可能，管理应采用MDT方法。根据疾病的分期和部位，治疗选择可能包括手术、放疗和化疗等非手术选择或联合治疗。应监测患者是否有疾病复发的任何迹象。据说局限性远端尿道癌的预后较好。
