|Year : 2002 | Volume
| Issue : 2 | Page : 172-173
Urethral cancer in a patient on CIC: A case report
Ajay Kanbur, Arundhati Kanbur, Nisar Ansari
Department of Urology & Internal Medicine, Shivneri Hospital, Thane, India
Shivneri Hospital, Agra Road, Thane - 400 602
Source of Support: None, Conflict of Interest: None
Keywords: CIC; Urethral Neoplasm
|How to cite this article:|
Kanbur A, Kanbur A, Ansari N. Urethral cancer in a patient on CIC: A case report. Indian J Urol 2002;18:172-3
| Case Report|| |
A 73-year-old male presented with narrow stream and a perineal wound. Following a TURP (1992), he underwent optical urethrotomy for bulbar stricture (1996) and was on a short-term CIC using Tiemann catheter. He had a left nephrectomy scar (1998). He continued CIC whenever his stream worsened, without consulting his physician.
Five months ago, he developed a perineal abscess, requiring surgical drainage. Soon, a sinus developed but failed to heal despite medication and suprapubic cystostomy. Within fifteen days of diversion, a fungating mass replaced the sinus [Figure - 1] with palpable left inguinal node.
Biopsy of sinus edge and FNAC of node revealed a welldifferentiated squamous cell carcinoma. Fistulogram revealed an irregular tract leading to a distorted bulb [Figure - 2]. Haemogram, Chest X-rays and abdominal CT scans were normal.
Cystoscopy revealed an irregular hard expanded bulb, with leakage of irrigant through the sinus. Bladder could not be entered.
Patient refused radical surgery, and opted local excision with life-long suprapubic catheter. At operation, the bulbar mass, extending into left ischio-rectal fossa was excised. Proximal bulb was disconnected. Histology confirmed squamous cell carcinoma with metaplasia in surrounding urethra.
| Comment|| |
Primary male urethral cancers are rare, three-fourths being squamous cell carcinoma.  They masquerade as perineal abscesses.  Medline search of a possible association of long term CIC and urethral cancer yielded no results. In our case, precise duration of CIC is unknown and, repeated trauma is probably responsible. Males on long-term CIC should be observed for possible signs of urethral cancers.
| References|| |
|1.||Johnson DE, Swanson DA, von Eschenbach AC. Tumours of the Genitourinary tract. In : Tanagho EA. McAninch JW (eds.). General Urology. 12 th edn. Prentice-Hall 1988: 19: 330-434. |
|2.||Singla SL. Sultania NK, Chitkara N, Singh U, Singh B. Peri-urethral abscess - a rare presentation of urethral carcinoma. J Indian Med Assoc 1997: 95: 90. |
[Figure - 1], [Figure - 2]