[Urethral ectropion may hide a carcinoma!]

The incidence of female urethral cancer is rare and accounts for 0.02% of all women's cancers. It is dominated by epidermoid carcinoma, which most commonly develops in the distal portion of the urethra, extending to inguinal lymph nodes. The diagnosis is confirmed in the distal forms on the basis of uretrocystoscopy with biopsy. Abdominopelvic MRI allows to determine tumor extension as well as its infiltration into tissues and peri-urethral organs. As in superficial tumors of the distal urethra, simple circumferential resection of the urethra associated with resection of the adjacent portion of the anterior surface of the vagina is sufficient. We here report the case of a 59-year old diabetic and hypertensive female patient presenting for irritative lower urinary tract symptoms, associated with vulvar mass. Clinical examination showed mucosal ectropion extending from the urethral meatus associated with extensive local inflammation. The patient underwent wide excision of the ectropion which was diagnosed as squamous cell carcinoma. Abdominopelvic MRI was normal.