Aggressive combined-modality therapy for squamous cell carcinoma of the female urethra.

BACKGROUND: A 48-year old woman presented to an emergency department with acute urinary retention necessitating suprapubic catheterization. INVESTIGATIONS: Pelvic examination under anesthetic by both a urologist and gynecologist, biopsy of the urethral tumor and of the cervix, pathological analysis, MRI of the pelvis, CT of the chest, abdomen and pelvis. DIAGNOSIS: Poorly differentiated squamous cell carcinoma of the urethra, T4N0M0. MANAGEMENT: The patient received two cycles of neoadjuvant TIP (paclitaxel, ifosfamide, cisplatin) chemotherapy, resulting in complete remission, followed by consolidative chemoradiation therapy (radiation therapy given with synchronous weekly cisplatin). She remained relapse-free 48 months after diagnosis, with normal voiding and sexual function.