Penis & scrotum

Male urethra

Male urethral carcinoma

Last staff update: 20 December 2022 (update in progress)

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PubMed Search: Male urethral carcinoma

Jesus Adrian Chavez, M.D.
Debra L. Zynger, M.D.
Page views in 2022: 1,990
Page views in 2023 to date: 1,730
Cite this page: Chavez J, Zynger DL. Male urethral carcinoma. website. Accessed September 21st, 2023.
Definition / general
  • Rare primary neoplasm of epithelial origin
  • Secondary involvement by urothelial carcinoma of the bladder is much more common than primary (Eur Urol 2013;64:823)
Essential features
  • Urethral carcinoma is usually due to secondary involvement
  • Primary urethral carcinoma is rare and the most frequent histologic types are urothelial carcinoma, squamous cell carcinoma and adenocarcinoma (not otherwise specified, clear cell)
  • Predisposing factors include:
Clinical features
  • Most patients present with symptoms associated with locally advanced disease (Eur Urol 2013;64:823)
    • Gross hematuria or bloody urethral discharge, dysuria, extraurethral mass
    • Bladder outlet obstruction, pelvic pain, urethrocutaneous fistula
    • Abscess formation, dyspareunia
  • Approximately 33% of men and women present with involved regional lymph nodes
  • Clinical examination with palpation of external genitalia for suspicious indurations and pelvic exam in women (Eur Urol 2013;64:823)
  • Urinary cytology
  • Diagnostic urethroscopy and biopsy
Radiology description
  • Aims to assess local extent and detect lymphatic and distant metastatic spread
  • Magnetic resonance imaging for evaluating extent of tumor and monitoring response to neoadjuvant chemotherapy (Eur Urol 2013;64:823)
Prognostic factors
Case reports
Gross images

Contributed by Jesus Adrian Chavez, M.D. and Debra Zynger, M.D.

Penile urethra with periurethral involvement

Microscopic (histologic) description
  • Urothelial carcinoma
  • Squamous cell carcinoma
    • Sheets of large, pleomorphic tumor cells with focal or abundant keratinization (depending of grade of differentiation), ample cytoplasm, intercellular bridges, high mitotic activity, prominent nuclear atypia
  • Adenocarcinoma
  • Clear cell adenocarcinoma
    • May have glandular, tubulocystic, solid / diffuse, papillary or micropapillary growth patterns
    • Cuboidal, variably sized cells with abundant clear or eosinophilic cytoplasm and cytoplasmic vacuoles
    • Nuclei that are hyperchromatic, pleomorphic and have prominent nucleoli
    • Hobnail changes and extracellular mucoid material may be present
    • Mitoses and necrosis are often seen
Microscopic (histologic) images

Contributed by Jesus Adrian Chavez, M.D. and Debra Zynger, M.D.

Low grade noninvasive papillary urothelial carcinoma

Penile urethra, squamous cell carcinoma

Penile urethra, HPV+ high risk ISH

Necrosis and keratinization

Clear cell adenocarcinoma:

Can mimic nephrogenic metaplasia

With hobnailing

With prominent clear cells and diffuse, sheet-like growth

Positive stains
Negative stains
Differential diagnosis
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