Diagnostic Conundrum In Prostatic Urethral Cancer: Is It Primary Or Secondary?

GASOC International Conference 2025
ABSTRACT FIRST PRESENTED: 24.10.2025

doi: 10.52648/GASOC.1006_320

Diagnostic Conundrum In Prostatic Urethral Cancer: Is It Primary Or Secondary?

Philip O. Abolanle , Adam Bennett
Aneurin Bevan University Health Board, Newport, United Kingdom

Introduction: Urethral adenocarcinoma is extremely rare. There is general paucity of literature and guidelines in managing this condition. We present a case of urethral adenocarcinoma which posed significant diagnostic dilemma.

Clinical presentation: A 70 year old man, previously treated for a caecal pole tumour, presented with high pressure chronic urinary retention and an abnormally feeling prostate. PSA was 0.8ng/ml at the time and MRI prostate showed a T4 Likert 5 prostate disease involving the bladder neck, seminal vesicles, ureters and the rectum. A subsequent prostate biopsy revealed adenocarcinoma with enteric features, consistent with colonic metastasis in the prostate. He was discussed in Colorectal and Urology multi-disciplinary team meetings and subsequently had pelvic exenteration. The tumour macroscopically appeared to be arising from the prostatic urethra. Post-operative histology was quite complex showing adenocarcinoma with enteric morphology. CK20 was positive, while CK7, NKX3.1 and PSA were negative on immunohistochemistry. Final histological differential diagnoses were primary adenocarcinoma of the prostatic urethra with mucinous/enteric features or metastatic colonic adenocarcinoma to the prostatic urethra. Due to paucity of data on urethral adenocarcinoma, there was no basis for further treatment, and he was discharged. He developed pulmonary nodules two years later which were found to be metastatic colonic adenocarcinoma and is currently undergoing treatment.

Conclusion: This is an unusual case and posed diagnostic challenges. Urethral carcinoma is rare and the data available on this topic are limited. There are no guidelines for its management due to paucity of evidence.

Keywords: urethral cancer, adenocarcinoma, urethra, prostate, cancer, colonic adenocarcinoma

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