De Novo and Postradiation Adenocarcinoma of the Urethra

Herein, we report the results of clinicopathologic and radiographic analyses of 55 patients with primary adenocarcinoma of the urethra. Their ages at diagnosis ranged from 42 to 88 years (mean: 66 y). Twenty-six patients were male and 29 were female (ratio: 1.0:1.1). We noted 2 distinct groups of cases: de novo urethral adenocarcinoma (n=45) and urethral adenocarcinoma in patients after radiation therapy for prostatic adenocarcinoma (n=10), defined as postradiation adenocarcinoma. Postradiation tumors developed 8 to 25 years (mean: 15.6 y) after radiation therapy. Eight patients underwent brachytherapy. Among the 45 patients with de novo adenocarcinoma, 29 were female, for a female-to-male ratio of 1.8 to 1.0. In 17 female patients with de novo urethral adenocarcinoma, tumors developed in a urethral diverticulum. Histologically, urethral adenocarcinomas exhibited adenocarcinoma not otherwise specified or clear cell, mucinous, enteric, and adenoid cystic carcinoma morphology. In 2 cases of de novo adenocarcinoma and 3 cases of postradiation adenocarcinoma, the tumors progressed to sarcomatoid carcinoma. The mean disease-specific survival time for the entire cohort was 100.35 months. As reflected by the Kaplan-Meier curves for these patients, the patterns of disease-specific survival were similar in the de novo and postradiation groups.