Urethrectomy with glans reconstruction and meatoplasty for rare high-grade urothelial carcinoma in distal urethra

Urethral cancer is rare, with urothelial, squamous, and adenocarcinoma as the main histological subtypes. Distal urethral cancers are typically squamous, while urothelial carcinoma (UC) in this region is uncommon. We report a man who developed high-grade UC of the distal urethra eight years after excision of a prior squamous cell carcinoma (SCC) at the same site—to our knowledge the first reported case of sequential SCC and UC in this location. He underwent partial glansectomy and distal urethrectomy with reconstruction, revealing invasive UC with lymphovascular invasion and negative margins. This case highlights the need for long-term surveillance after urethral malignancy.