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.
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