Clinical case description:

A 64-year-old woman with an unremarkable past medical history was evaluated due to lower urinary tract symptoms and hematuria of 1-month progression. A magnetic resonance imaging scan revealed a lesion consistent with urethral tumor. During urethrocystoscopy, a tumor was found inside a urethral diverticulum. Transurethral resection was carried out, followed by the later performance of anterior pelvic exenteration. The histopathologic result was clear cell adenocarcinoma inside a proximal urethral diverticulum. The patient did not undergo adjuvant therapy, remaining in follow-up and surveillance, and is presently recurrence-free.

Relevance:

Urethral carcinoma is an uncommon tumor and its appearance in a diverticulum is rare. Those types of tumor are highly invasive and require aggressive treatment to offer the possibility of cure.

Clinical implications:

No standardized treatment is in place. Surgical treatment through radical urethrectomy or anterior pelvic exenteration, with or without adjuvant therapy, is the most widely accepted therapeutic option.

Conclusions:

Clear cell adenocarcinoma arising in a urethral diverticulum is uncommon and usually has a locally advanced presentation. There is no standardized treatment or follow-up for the disease.

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