Byun Jungsup, Park Nora Jee-Young, Seo An Na, Yoon Ghilsuk
Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Department of Pathology, Daegu Fatima Hospital, Daegu, Republic of Korea.
Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
Int J Surg Case Rep. 2025 Oct;135:111881. doi: 10.1016/j.ijscr.2025.111881. Epub 2025 Aug 29.
Urethral caruncle is one of the most prevalent urethral inflammatory disease in postmenopausal females. Although urethral caruncle is neither neoplastic nor preneoplastic, there have been rare reports of malignant neoplasm arising from them. Furthermore, none of them revealed association between urethral caruncle lesion and HPV (human papilloma virus) infection.
We herein report a case of an 80-year-old female with squamous cell carcinoma in situ arising from the urethral caruncle, which was found to be associated with HPV infection. The 1.5 cm-sized mass located at posterior aspect of urethral meatus, was clinically suspected urethral caruncle.
After caruncle excision was performed, histopathological result demonstrates severe squamous dysplasia with koilocytic atypia, involving the whole thickness of squamous epithelium. No invasive tumour cell was identified, consistent with squamous cell carcinoma in situ. The lesion showed block positivity in p16 immunohistochemical staining, which is the surrogate marker for the cytopathic incorporation of human papilloma virus. In the following molecular study, viral expression of HPV was confirmed by real time PCR with detection of high-risk HPV subtype 39.
Squamous cell carcinoma originating from a urethral caruncle is an exceptionally uncommon occurrence. A comprehensive review on the English-written literature yielded only three previously documented case reports.
尿道肉阜是绝经后女性中最常见的尿道炎性疾病之一。尽管尿道肉阜既不是肿瘤性病变也不是癌前病变，但有罕见报道称其可发生恶性肿瘤。此外，此前尚无报道显示尿道肉阜病变与HPV（人乳头瘤病毒）感染之间存在关联。
我们在此报告一例80岁女性患者，其尿道肉阜发生原位鳞状细胞癌，且发现与HPV感染有关。位于尿道口后方的1.5厘米大小肿物，临床怀疑为尿道肉阜。
切除肉阜后，组织病理学结果显示为重度鳞状上皮发育异常伴挖空细胞异型性，累及鳞状上皮全层。未发现浸润性肿瘤细胞，符合原位鳞状细胞癌。病变在p16免疫组化染色中呈块状阳性，p16是人类乳头瘤病毒细胞病变整合的替代标志物。在随后的分子研究中，通过实时PCR检测到高危HPV 39亚型，证实了HPV的病毒表达。
起源于尿道肉阜的鳞状细胞癌极为罕见。对英文文献的全面检索仅发现三篇既往报道的病例报告。
