8-year disease-free survival after surgery alone for clear cell adenocarcinoma of the urethraSurgery alone yields 8-year survival in rare urethral cancer

This is a case report and literature review describing a 39-year-old woman diagnosed with clear cell adenocarcinoma of the urethra (CCAU), a rare malignancy. The patient underwent surgery alone, consisting of laparoscopic radical cystectomy, lymph node dissection, and cutaneous ureterostomy. The primary outcome was disease-free survival, and the patient remained recurrence-free for 8 years through January 2025. No adjuvant therapy was administered.

The authors highlight that this is one of the longest reported disease-free survivals for CCAU treated with surgery alone. The literature review contextualizes the case within the sparse evidence on this tumor type, where treatment approaches vary and outcomes are generally poor.

Limitations include the small sample size inherent to a case report, which precludes generalizability. No adverse events or safety data were reported. The findings should be interpreted cautiously and not extrapolated to the broader population of patients with CCAU.

For clinicians, this case underscores that radical surgery may achieve durable remission in select patients with localized CCAU, but treatment decisions must be individualized given the lack of comparative data.