A case of intraepithelial squamous cell carcinoma arising from urethral caruncle

Abstract

A 62-year-old female patient had occasional bleeding from a mass in the urethral meatus. She had been conservatively treated with steroid ointment at another hospital for 1 year, but the bleeding had persisted. The patient was therefore referred for further treatment. A reddish mass, measuring 5 mm in diameter was noted at the posterior lip of the urethral meatus. The mass was diagnosed to be a urethral caruncle and was removed. Microscopically, the squamous epithelium, which covered the urethral caruncle, was found to be keratinized, with the proliferation of atypical cells with swollen nuclei in the entire mucosal layer. The mass was finally diagnosed to be intraepithelial squamous cell carcinoma arising from the urethral caruncle.The occurrence of intraepithelial squamous cell carcinoma arising from a urethral caruncle is extremely rare. A search of the English literature revealed only 1 other case report.

Urethral hemangioma in a prepubertal female patient

“…About a quarter of the urethral mucosa protrudes as a caruncle, which consists of connective tissue containing many inflammatory cells and blood vessels, and is often present at the posterior lip of the urethral meatus. [15,16] The protruding nodule in our patient was located in the ventral lip of the urethral meatus, which is not the common location of a caruncle. Common malignancies of the urethra include squamous cell carcinoma, urothelial cell carcinoma, adenocarcinoma, sarcoma, and melanoma.…”

A Rare Cause of Acute Urinary Retention: Urethral Caruncle

“…Although caruncles are usually benign, they should be surgically excised and histopathologically examined since they may be the indicators of lymphoma, clitoral venous thrombosis, urethral thrombosis, pseudoneoplastic lesions, urethral polyps, malign melanoma, intestinal heterotypic, angiomatous lesions, and diastolic urethral stenosis (5,6,7,8,9,10,11).…”

Urethral caruncle: Case report of a rare acute urinary retension cause

“…These disorders include urethral thrombosis, pseudoneoplastic lesion, lymphoma, clitoral vein thrombosis, ureteral polyps, malignant melanoma, carcinoma, intestinal heterotype, angiomatous lesions and distal urethral stenosis. [4][5][6][7][8][9][10] Although the initial medical treatment of urethral caruncle is topical estrogen and anti-inflammatory treatment, we believe that the most effective form of treatment is total excision. Total excision is preferred because the mass can be large enough to make urinating difficult; there is also a small chance of malignancy.…”