Urethral Cancer in Females
Paul Ostri, Anne Marie Worning, Brigitte Dalum
A case of female urethral cancer with late diagnosis on account of concomitant complaints is presented. When persistent urethral symptoms or localized pain are found the diagnostic procedure should include urethrocystoscopy. Paul Ostri, MD, Dickens Allé 48, DK-2860 Söborg (Denmark) Urethral cancer is a very rare cancer form in both sexes, with a female/male ratio of 5:1 . It accounts for less than 0.02% of malignant tumors in females. The 5-year survival rate for both sexes is less than 40%
... 1]. This poor prognosis is probably partly due to late diagnosis. The symptoms are uncharacteristic and often thought to be derived from other urological or gynecological disorders. A case of fatal female urethral cancer with late diagnosis is presented. Case Report A 51 -year-old female was admitted to the gynecological department with the diagnosis of ovarian tumor. For 3 weeks prior to admittance the patient had suffered from urological symptoms in the form of perineal pain with exacerbation during micturition, pol-lakisuria, nycturia and residue. Gynecological symptoms were in the form of metrorrhagia. External examination revealed a 5 X 5 cm large palpable tumor in the suprapubic region. Gynecological examination revealed a normal vagina, and an enlarged uterus (3 times normal size) with many irregular fibromas. Hb and se-creatinine were normal. Intravenous urography showed tumor masses in the pelvis. Hysterectomy and bilateral salpingo-oophorectomy was performed with an uncomplicated postoperative period. Histological diagnosis: fibroleiomyoma uteri, no malignancy. 2 months later the patient was readmitted with urinary discharge in the vagina and unchanged perineal pain and dysuria. Urethrocys-toscopy showed a normal bladder, but two urethrovaginal fistulas situated 1 and 2 cm from the internal urethral orifice. Bioptic material from these areas was classified as squamous carcinoma, probably primary urethral cancer. X-ray of the lungs, and lymphography, were without signs of metastases. Cystectomy and urethral excision were performed with construction of an ureteroiliocutaneostomia (Bricker bladder).