Clear cell adenocarcinoma of posterior urethra- A rare histological subtype of female genitourinary cancer

Abstract

Urethral Clear cell adenocarcinoma is a very rare variant of lower urinary tract malignancy. We present a 62-year old lady who complained of hematuria, obstructive urinary symptoms and pain abdomen. Her MRI pelvis revealed a mass in the posterior urethra measuring 30x20x15mm. Further she underwent total urethrectomy with regional lymph node dissection. Histology demonstrated features consistent with clear cell adenocarcinoma with 8/29 positive lymph nodes. Immunohistochemically cells were positive for CK7(+4), CD10(+4), HMWCK(+2) and PAX-8(+3). Whilst it was non- immunoreactive for GATA3, CK20, uroplakin and p-63. Subsequent PET scans have demonstrated lymphatic disease progression, and later on, the patient succumbed to disease after one year of diagnosis.