Primary bulbar urethral adenocarcinoma arising from intestinal-type villous adenoma: a rare malignant entity

Primary urethral adenocarcinoma is rare, with limited guidance for management. A 65-year-old male presented with haematuria and urinary retention, found to have a bulbar urethral tumour at the site of previous stricture. Histology demonstrated moderately differentiated adenocarcinoma arising from an intestinal-type villous adenoma with high-grade dysplasia. Staging excluded metastatic or alternative primary disease. He underwent subtotal urethrectomy with perineal urethrostomy, achieving clear margins. Mild postoperative stenosis was managed conservatively. At one year, there is no recurrence. This case describes gastrointestinal adenocarcinoma in the setting of urethral stricture disease and highlights tailored surgical management in achieving favourable oncological and functional outcomes.