[Epidermoid carcinoma of the male urethra. Our experience in 5 cases]

Abstract

Objectives: Epidermoid carcinoma of the male urethra is a rare tumor that accounts for 70% of primary neoplasms of the urethra. The present study reviews our experience of 5 years in the diagnosis and treatment of this tumor type.

Methods: From 1991 to 1994, we diagnosed and treated 5 male patients with epidermoid carcinoma of the urethra; mean age 58 years (range 43 to 76 years). The tumor was localized in the bulbomembranous urethra in 3 cases (60%) and in the penile urethra in the remaining 2 cases (40%). All patients presented with urethral stricture and complications following treatment (internal urethrotomy and dilatation). The tumors of the posterior urethra were Levine stage C and D at the time of diagnosis, while those of the anterior urethra were Levine stage B and C.

Results: Two patients with tumor in the posterior urethra underwent radical cystoprostatourethrectomy and bilateral inguinal lymphadenectomy, whereas the remaining patients underwent emasculation or urethrectomy. Patient survival has ranged from 1 to 2.5 years at the present time. One patient with tumor in the bulbous urethra has died despite postoperative radio and chemotherapy, the outcome has been poor in another patient with tumor in the posterior urethra and no progression has been observed in the remaining patients at present.

Conclusions: a) Urethral stricture with a torpid course and localized complications (fistula, periurethral abscess, etc.) following standard therapy have been the only widely accepted etiologic factors that we have observed in our patients; b) This tumor type must be suspected since treatment by radical surgery will have some likelihood of success if the carcinoma is diagnosed early, while it is still localized; c) To date, radio and chemotherapy have achieved poor results, the former being effective in tumors of the penile urethra only when given at a high dose; d) Patients generally die from localized complications, tumor recurrence, or lymph node metastasis (sepsis, hemorrhage, etc.).