Squamous cell carcinoma of the urethra

Squamous cell carcinoma arises in the distal (penile or anterior) urethra in men and the distal urethra and meatus in women, where the lining is squamous, and in the EAU classification it is one of the three principal histologies of primary urethral carcinoma with urothelial carcinoma and adenocarcinoma (Gakis 2013). It made up 30 percent of the 154 patients in the international collaboration (Gakis 2016). The parent page notes HPV in a proportion of cases, and p16 staining is listed among its terms.

How it differs from its parent: its site is distal, so it presents with a palpable mass, bleeding or obstruction near the meatus and drains to the inguinal nodes, like penile and vulval cancer, rather than to the pelvic nodes; that changes the surgery and the radiotherapy fields. Its treatment is borrowed from anal and vulval squamous cell carcinoma rather than from bladder cancer.

How common: no incidence figure for the squamous type alone is published; the parent's figure of fewer than one case per million a year covers all types.

Treatment follows the EAU guideline for the parent, with no randomised trial: local excision or partial urethrectomy for small distal tumours, and for larger or node-positive disease chemoradiation with fluorouracil and mitomycin or cisplatin, as in anal cancer, so that the urethra can be kept (EAU Guidelines: primary urethral carcinoma; NCI PDQ). Inguinal node management follows penile and vulval cancer practice as the parent page describes.