Primary carcinoma of the male urethra developing after urethroplasty for stricture

Most investigators agree that a urethral stricture is a predisposing cause of primary carcinoma of the urethra. The etiology of the carcinoma is probably chronic irritation. The role of squamous metaplasia in the etiology is discussed briefly. A case of primary squamous cell carcinoma of the urethra occurring 4 years after a first stage urethroplasty is reported and 2 cases from the literature are described. The suggested origins of urethral malignancy after urethroplasty are 1) unrecognized malignancy at operation, 2) premalignant mucosal changes that progress postoperatively, 3) recurrence of stricture with continued irritation leading to malignant metaplasia and 4) malignant change in the urethroplasty skin flaps. Although rare, primary male urethral carcinoma is a deadly disease. The hope for early diagnosis is a high index of suspicion during urethroplasty and in subsequent followup studies. The patient presented herein also exhibited pseudohyperparathyroidism as a result of the malignancy.