Introduction: Urethra constitutes a place where other genitourinary malignancies frequently spread to. Primary urethral carcinoma (PUC) is a rare urinary tract tumour, comprising less than 1 % of malignancies that affect male patients. It is considered to be an aggressive tumour which is usually underdetected and also unsatisfactorily treated.
Primary urethral carcinoma (PUC) is a rare malignancy with a poor prognosis. Tumour site constitutes an important prognostic factor. Histology is also fundamental. Urothelial carcinoma is an infrequent subtype of PUC. Owing to its rare nature , histopathological study is so important. GATA3 has been explored as a marker for urothelial carcinoma. Therapeutic management also depends on the clinical stage and tumour site. Penile- preservative surgery can be an option in selected patients. Disease-free survival is variable, being able to reach up to 90% in those of distal location.
We´re presenting a case of a urothelial carcinoma in anterior urethra presented with a bleeding penis mass without any other urinary tract findings.
Clinical findings: An 82-year-old-male, smoker and with high blood pressure ‘s genital examination revealed a bleeding penis mass which affected distal urethra. It was first presented as urinary hesintacy. No local adenopathies were found. No other relevant findings were found either.
Diagnosis & Treatment: The urologist took a biopsy of the lesion. A detailed examination of the piece was performed by the Pathologist. Final histological result was reported as urothelial high grade carcinoma. CT didn’t reveal any other urinary tract tumours. Cystoscopy didn’t find any intravesical lesions either. The patient finally underwent surgery with a partial penectomy. Postoperative follow up was satisfactory. The patient was discharged from the hospital three days after surgery.
Primary urethral carcinoma (PUC) is a rare malignancy with a poor prognosis. Tumour site constitutes an important prognostic factor. Histology is also fundamental. Urothelial carcinoma is an infrequent subtype of PUC. Owing to its rare nature , histopathological study is so important. GATA3 has been explored as a marker for urothelial carcinoma (this technique was used in our case). Therapeutic management also depends on the clinical stage and tumour site.
Penile- preservative surgery can be an option in selected patients. Disease-free survival is variable, being able to reach up to 90% in those of distal location.
Conclusions: Primary urethral carcinoma is a rare condition that Urologists should bear in mind when they find suspicious urethral lesions. Phallus preservative surgery is an option that should be offered to selected patients.

Urothelial carcinoma in anterior urethra. An infrequent subtype of primary urethral carcinoma. A case report