Primary urethral carcinoma mistaken as a caruncle: A case report

Abstract

Introduction: Urethral caruncles are the most common benign urethral lesion in females, especially in post-menopausal women. In rare cases, primary urethral carcinoma can develop from a caruncle. Case Report: We present a case of primary urethral carcinoma in a patient who presented with urethral tenderness and what appeared to be a benign urethral caruncle. After failing conservative therapy, she underwent excision of the lesion, which revealed moderately differentiated invasive squamous cell carcinoma. She then underwent excision of the distal urethra and anterior vaginal wall. No residual disease was discovered and she recovered well without symptoms of stress urinary incontinence. Conclusion: Excision of a urethral caruncle is indicated in a symptomatic patient not responding to conservative therapy in order to rule out an underlying malignancy.