Urethral cancer managed with phallus preserving surgery: a case report
Emily Walsh1, Niall Kelly2, Padraig Daly2
1Department of Urology, Department of Surgery, University Hospital Waterford, Waterford, Ireland. emilywalsh@rcsi.ie.
Journal of Medical Case Reports
|February 20, 2021
Summary
Primary urethral carcinoma is rare, often challenging to diagnose early. Penis-preserving surgery offers a viable treatment option, maintaining normal function for patients with this uncommon cancer.
Area of Science:
- Urology
- Oncology
Background:
- Primary urethral carcinoma (PUC) is a rare genitourinary cancer, comprising less than 1% of cases.
- It predominantly affects males in their 7th and 8th decades, with human papilloma virus (HPV) implicated in tumorigenesis.
- Diagnosis and staging require a multimodal approach including biopsy, MRI, and CT scans.
Observation:
- A case of distal urethral carcinoma presented initially as a metastatic groin mass, complicating primary lesion identification.
- Flexible cystoscopy revealed a small squamous cell carcinoma in the navicular fossa.
- The patient underwent phallus-preserving surgery (distal urethrectomy) with bilateral inguinal lymph node dissections.
Findings:
- The final pathological stage was pT1N1M0, with adjuvant chemotherapy initiated.
- Distal urethrectomy resulted in a hypospadic meatus in the midshaft of the penis.
- The patient preserved normal voiding and sexual function post-surgery.
Implications:
- Early diagnosis of urethral cancer can be difficult due to tumor location.
- Current treatment trends favor penis-preserving surgical techniques.
- Multimodal management and organ-sparing approaches are crucial for managing primary urethral carcinoma.
