Robot-assisted laparoscopic management of primary urethra clear cell adenocarcinoma in females: a case report and literature review.

BACKGROUND: Primary clear cell carcinoma of the urethra (CCAU) in women is extremely rare. There are only limited reported cases in the literature, with no standardized treatment protocol presently available. This article aims to explore the clinical characteristics, diagnostic difficulties, treatment strategies, and prognosis of female primary clear cell adenocarcinoma of the urethra, and supplement it with relevant literature analysis to improve the understanding of this rare disease. METHODS: A 57-year-old female patient presented with progressive dysuria for half a year and recurrent urinary retention for 2 months. After evaluation by imaging, endoscopic, and pathological examinations, the patient underwent robot-assisted laparoscopic radical resection of urethral cancer, with the postoperative pathology finally diagnosed as CCAU. Innovative surgical positioning and auxiliary methods were employed during the operation to effectively optimize the treatment and promote the smooth progress of the operation. RESULTS: Postoperative pathology revealed urethral clear cell adenocarcinoma with sarcomatoid differentiation in some areas. The patient underwent a successful surgical procedure with an uneventful postoperative recovery. Follow-up imaging showed no signs of tumor recurrence. The patient experienced a postoperative complication of urinary incontinence. CONCLUSION: CCAU is a rare and highly malignant tumor with poor prognosis. The diagnosis of this disease primarily relies on pathological immunohistochemistry and differential exclusion of metastatic tumors. Multidisciplinary collaboration and radical surgery are key to successful treatment, with consideration given to adjuvant therapy and close postoperative follow-up. At present, no standard surgical regimen exists, and the efficacy of postoperative adjuvant therapy remains unclear.