Unusual Features of Clear Cell Adenocarcinoma of the Female Urethra: A Case Report and Literature Review

BACKGROUND: There has been scarce information about clear cell adenocarcinoma of the urethra (CCAU), an extremely rare type of cancer. A few case reports show that CCAU tends to have similar clinical manifestation to the other urethral carcinomas, urethrocystoscopy can easily identify tumoral lesions in the urethra, and bloody drainage from the urethral meatus is often seen during physical exams. METHODS: A 52-year-old woman presented with dysuria for 6 months. Urethrocystoscopy did not reveal abnormality, and there was no bloody vaginal drainage or bloody drainage from the urethral meatus during physical exams. Ultrasonography demonstrated a solid mass with well-defined margins located between the anterior vaginal wall and the posterior urethral wall. Computed tomography showed the mass with smooth margins at the level of vaginal fornix, and magnetic resonance imaging showed the same location of the tumor as ultrasonography. RESULTS: Surgical removal of the tumor was successfully performed and histological and immunohistochemical analysis confirmed the final diagnosis of CCAU. CONCLUSION: Abnormality in urethrocystoscopy and bloody drainage during the physical exam were not found in this case, which is in contrast to the findings reported in literature. These unusual features add new knowledge about CCAU that deserves dissemination for improved CCAU diagnosis and management.