Squamous cell carcinoma of female urethral meatus

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Known for endometrial carcinoma treated with surgery on follow-up. Recent history of urinary retention

Patient Data

Age: 60 years
Gender: Female

No uterine structure is seen (history of hysterectomy with bilateral salpingo-oophorectomy for endometrial carcinoma). No pelvic mass or lymphadenopathy is seen.

A small soft tissue nodule centered on the urethral meatus isointense to muscles on T1, slightly hyperintense on T2, and DWI with a low ADC (restricted diffusion). The postcontrast demonstrates a vivid enhancement on the dynamic sequences.

Case Discussion

Enhancing soft tissue nodule with restricted diffusion centered on the urethral meatus pathologically proven as squamous cell carcinoma.

The histologic types of urethral cancer are transitional cell carcinoma in 55%, squamous cell carcinoma in 22%, and adenocarcinoma in 16%. Sarcoma or melanoma are rarely seen.

In males, the bulbomembranous urethra is the most involved in 60% of the cases, followed by the penile urethra (30%) and prostatic urethra (10%). 

In females, the anterior segment (distal two-thirds) is involved in 46% of the cases. The posterior segment (proximal third) is responsible for the remainder of cases. 

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