Metastatic Clear Cell Adenocarcinoma of the Urethra in a Male Patient: Report of a Case

Abstract

A 39-year-old white male presented with urinary hesitancy 2.5 years ago. He was referred to a urologist who performed cystoscopic evaluation and discovered a urethral mass with no abnormalities in the bladder. A staging positron emission tomography (PET) scan revealed fluorine-18 (F) fluorodeoxyglucose (FDG) uptake in a soft tissue prominence in the urethra and bilateral inguinal and iliac FDG-avid lymphadenopathy. Computed tomography (CT) of the hest also demonstrated several bilateral lung nodules. Needle biopsy f a left pelvic lymph node showed adenocarcinoma with micropapllary architecture (Figure 1A). Immunohistochemical analysis howed the carcinoma was positive for CK7 and CAM 5.2 and negtive for CK20, -fetoprotein, CDX-2, and prostate-specific antigen the immunostains are not shown). Sections from the subsequent ransurethral resection specimen of the urethral tumor showed an denocarcinoma with a tubulocystic, micropapillary, and solid archiecture (Figure 1B-D). The tumor had hobnail cells, clear and amhophilic cytoplasm, and high-grade nuclear atypia (Figure 1E). An