Adenocarcinoma of the urethra with mucinous features

Abstract

Primary adenocarcinoma of the female urethra is a rare malignancy. Previous studies hypothesize multiple origins, including periurethral glands or intestinal metaplasia. We report a case of a 60-year-old white woman with adenocarcinoma of the urethra who initially presented with obstructive voiding complaints secondary to a urethral mass. Wide local excision revealed invasive adenocarcinoma of the urethra with mucinous features. There was intestinal metaplasia adjacent to the tumor, as well as separate identification of intestinal metaplasia along the urethra. Ultimately, the patient underwent radical cystectomy with ileal conduit urinary diversion with no evidence of recurrence, indicating the role of early identification and surgical intervention for such cases.

Keywords: Genital tract tumor; Radical cystectomy; Skene gland; Urethra; Urethral adenocarcinoma.

Figure 1

Invasive adenocarcinoma with mucinous features (original magnification, ×200). Some areas contained adenocarcinoma glands floating in pools of mucin, which prompted the diagnosis of adenocarcinoma with mucinous features.

Figure 2

Invasive adenocarcinoma with mucinous features (original magnification, × 200). The typical columnar type adenocarcinoma can be seen infiltrating the subepithelial connective tissue with the tumor cells forming both individual glands and clusters of glands.

Figure 3

Mucinous metaplasia (original magnification, × 400). In sections adjacent to the tumor, metaplastic mucin-filled goblet cells can be seen intermixed with the normal urothelium.