Objective:

To report a case of clear cell adenocarcinoma of the urethra (CCAU) and provide updated follow-up data on the patient's long-term survival after surgical intervention.

Approach:

• Case Presentation: A 39-year-old woman presented with painless hematuria and was diagnosed with CCAU. Imaging showed a 5.1 cm urethral mass invading the bladder and vagina (clinical stage T3N2M0). She underwent laparoscopic radical cystectomy and lymph node dissection without adjuvant therapy.
• Follow-Up: The patient was followed for 8 years post-surgery, showing no recurrence of the tumor despite some complications related to pyelonephritis.

Key Findings:

• The patient achieved 8-year disease-free survival after surgical intervention.
• Histopathological examination confirmed clear cell adenocarcinoma with no lymph node metastasis.
• Urine cytology unexpectedly identified malignant cells, suggesting a potential non-invasive diagnostic tool.

Interpretation:

CCAU is a rare and aggressive cancer with poor prognosis, but this case demonstrates a successful long-term outcome following surgical treatment.

Limitations:

• The rarity of CCAU limits the generalizability of findings.
• No adjuvant therapy was administered, which may not reflect standard treatment protocols.

Conclusion:

This case highlights the potential for long-term survival in CCAU following surgical intervention, despite the generally poor prognosis associated with this malignancy.