Incidental bulbar urethral glomus tumour of uncertain malignant potential with concurrent prostate cancer

We present a case of a man in his 60s with an incidental bulbar urethral glomus tumour on investigation for an elevated prostate specific antigen (PSA) with a concurrent diagnosis of prostatic adenocarcinoma with Gleason 3+4 pattern. Glomus tumours are a rare entity in the genitourinary tract. When greater than 2 cm the malignant potential is unreported. Penectomy for a benign lesion can be psychosocially devastating however the differential diagnosis of sarcoma is aggressive and life-threatening. MRI is the gold standard to characterise the lesion and plan surgical excision. An organ-sparing approach was undertaken in a centralised penile cancer institution. Definitive prostate cancer treatment was delayed with comprehensive patient counselling until histopathology confirmed the benign nature of the urethral tumour and the primary anastomosis had healed. Radical prostatectomy was subsequently performed. A multidisciplinary approach to rare tumour types is strongly reinforced by this case.