A case of intraepithelial squamous cell carcinoma arising from urethral caruncle

A 62-year-old female patient had occasional bleeding from a mass in the urethral meatus. She had been conservatively treated with steroid ointment at another hospital for 1 year, but the bleeding had persisted. The patient was therefore referred for further treatment. A reddish mass, measuring 5 mm in diameter was noted at the posterior lip of the urethral meatus. The mass was diagnosed to be a urethral caruncle and was removed. Microscopically, the squamous epithelium, which covered the urethral caruncle, was found to be keratinized, with the proliferation of atypical cells with swollen nuclei in the entire mucosal layer. The mass was finally diagnosed to be intraepithelial squamous cell carcinoma arising from the urethral caruncle.The occurrence of intraepithelial squamous cell carcinoma arising from a urethral caruncle is extremely rare. A search of the English literature revealed only 1 other case report.