Primary Adenocarcinoma of the Bulbomembranous Urethra: Cause or Coincidence?

Abstract

A 73-year-old male patient was followed in our urology department after prostate cancer in 2004 and bladder cancer in 2011. In April 2013, during the last cystoscopy, a bulbomembranous stricture was found and an urethrotomy was easily performed. Shortly after the procedure, the patient starts complaining of urinary dysfunction and presents with a palpable firm mass in the perineum. An urethrocystoscopy was performed, showing no abnormalities. A pelvic CT-scan was then performed, revealing a complicated and large (6×7×4 cm) post-operative hematoma. After a trial of antibiotics, without any symptomatic improvement, a pelvic MRI showed a large heterogeneous mass, extending to the corporeal bodies and multiple enlarged inguinal and pelvic lymph nodes. He was than submitted to surgical exploration and the pathology report was consistent with primary urethral adenocarcinoma in both the perineum and the corporeal bodies. A new CT scan showed massive metastatic spread. He was proposed for chemotherapy but the prognosis is logically poor.