PMC9458263_01
Ascending urethrogram showing the irregular filling defect at the level of bulbo-membranous junction.
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This prompted us to perform a retrograde urethrogram where there was an irregular filling defect at the bulbo-membranous junction with the entry of contrast into the urinary bladder (Figure 1).
MRI images depicting a T2 hyperintense infiltrative mass involving the membranous urethra.
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T2 sequence revealed a high signal infiltrative mass of size 2 x 4 cm involving the membranous urethra, extending into the proximal bulbar urethra distally, prostatic urethra proximally and abutting the rectum posteriorly (Figure 2). There was no pelvic lymphadenopathy or ascites, and other abdominal organs were normal.
Total pelvic exenteration specimen.
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Therefore, total pelvic exenteration with bilateral extended pelvic lymphadenectomy was performed with ileal conduit and descending colostomy (Figure 3).
High-power view showing the typical signet ring cells (arrows) with nucleus pushed to the periphery by abundant intracellular mucin (Eosin and Hematoxylin stain, magnification 100x).
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Histopathological examination revealed a tumour in membranous urethra composed of lakes of mucin in which clusters of signet ring type carcinomatous cells were visible (Figure 4).