1521Vol. 11 | No. 02 | March- April 2014 |U R O LO G Y J O U R N A L Cavernous Hemangıoma of the Female Ure- thra: A Rare Case Report Sakir Ongun,1 Serdar Çelik,1 Güven Aslan,1 Kutsal Yörükoğlu,2 Adil Esen1 Corresponding Author: Sakir Ongun, MD Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey. Tel: + 90 232 412 3451 E-mail: sakirongun@hotmail.com Received January 2013 Accepted June 2013 1 Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey. 2 Department of Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey. CASE REPORT Keywords:‎Hemangioma;‎cavernous;‎female;‎urethra;‎treatment‎outcome. INTRODUCTİON Genitourinary‎hemangiomas‎are‎rare‎entities‎that‎can‎affect‎any‎portion‎of‎the‎uri-nary‎system.‎The‎urethra‎is‎rarely‎involved,‎and‎most‎reported‎cases‎have‎occurred‎in‎the‎male‎urethra.(1)‎To‎our‎knowledge‎few‎cases‎of‎hemangioma‎occurring‎in‎the‎ female‎urethra‎have‎been‎reported.(2,3)‎We‎report‎a‎cavernous‎hemangioma‎of‎the‎urethra‎in‎ a‎female‎patient. CASE REPORT A‎68‎years‎old‎woman‎presented‎with‎urethral‎mass‎and‎difficulty‎in‎voiding.‎The‎patient‎had‎ no‎hematuria‎episodes‎and‎no‎other‎related‎urological‎or‎medical‎history.‎On‎examination‎a‎ 2‎cm‎erythematous,‎polypoid‎mass‎was‎arising‎from‎the‎urethra‎(Figure‎1).‎It‎did‎not‎appear‎ to‎be‎an‎urethral‎caruncle.‎Laboratory‎values‎were‎normal.‎There‎was‎a‎clinical‎suspicion‎for‎ malignant‎tumor.‎Computed‎tomography‎(CT)‎scan‎of‎abdomen‎and‎pelvic‎floor‎was‎normal.‎ Excision‎of‎the‎urethral‎mass‎was‎planned.‎Before‎the‎excision‎cystoscopy‎was‎performed,‎ showing‎normal‎bladder‎neck‎and‎bladder‎mucosa.‎A‎Foley‎catheter‎was‎placed‎without‎ 1522 | difficulty.‎Then‎mass‎excised‎completely.‎The‎urethral‎mu- cosa‎was‎everted‎with‎interrupted‎3-0‎synthetic‎absorbable‎ sutures.‎In‎pathological‎examination,‎an‎encapsulated‎mass‎ was‎ composed‎ of‎ large,‎ cavernous‎ vascular‎ spaces‎ filled‎ with‎blood‎and‎separated‎by‎connective‎tissue‎stroma‎(Fig- ures‎2‎and‎3)‎which‎diagnosed‎as‎cavernous‎hemangioma‎of‎ the‎urethra.‎The‎Foley‎catheter‎was‎removed‎at‎the‎seventh‎ postoperative‎day‎and‎the‎patient‎was‎continent‎afterwards.‎ The‎patient‎had‎no‎symptoms‎at‎3-month‎follow-up‎with‎no‎ evidence‎of‎tumor‎recurrence. DISCUSSION Hemangiomas‎of‎the‎urinary‎tract‎are‎very‎rare‎and‎have‎ been‎described‎in‎the‎kidney,‎ureter,‎bladder,‎prostate‎and‎ urethra.(1)‎ Involvement‎ of‎ urethra‎ is‎ extremely‎ rare,‎ and‎ there‎have‎been‎only‎a‎few‎reported‎cases‎in‎women.(2,3)‎ The‎most‎common‎symptom‎is‎hematuria‎but‎patients‎can‎ also‎present‎with‎urethral‎mass. For‎ a‎ female‎ urethral‎ mass,‎ urethral‎ caruncle,‎ polyps,‎ prolapse‎and‎periurethral‎abscess‎should‎be‎taken‎in‎con- sideration‎ for‎ benign‎ entities.‎ Squamous‎ cell‎ carcinoma,‎ transitional‎cell‎carcinoma,‎adenocarcinoma,‎sarcoma‎and‎ melanoma‎are‎responsible‎of‎malign‎entities‎ in‎descend- ing‎sequence.‎These‎masses‎usually‎relapse‎in‎spite‎of‎their‎ benign‎nature.‎Treatment‎of‎urethral‎hemangiomas‎can‎in- clude‎observation,‎oral‎steroids‎and‎various‎modalities‎of‎ endoscopic‎treatment‎such‎as‎electrocautery‎or‎laser‎abla- tion.(4)‎ Single,‎ localized‎ lesions‎ should‎ be‎ removed‎ with‎ wide‎excision‎as‎these‎tumors‎have‎tendency‎to‎recur‎unless‎ completely‎excised. CONFLICT OF INTEREST None declared. Figure 1. Mass protruding from the urethra. Figure 2. Cavernous vascular spaces filled with blood, and some thrombosis. There is squamous metaplasia at the surface epithe- lium (×10). Figure 3. Urothelium at the surface and vascular structures with connective tissue stroma and inflammatory cells (×10). Case Report 1523Vol. 11 | No. 02 | March- April 2014 |U R O LO G Y J O U R N A L Cavernous Hemangıoma of the Female Urethra | Ongun et al REFERENCES 1. Jahn H, Nissen HM. Haemangioma of the urinary tract: review of the literature. Br J Urol. 1991;68:113-7. 2. Uchida K, Fukuta F, Ando M, Miyake M. Female urethral hemangio- ma. J Urol. 2001;166:1008. 3. Tabibian L, Ginsberg DA. Thrombosed urethral hemangioma. J Urol. 2003;170:1942. 4. Hayashi T, Igarashi K, Sekine H. Urethral hemangioma: case report. J Urol. 1997;158:539-40. 5. Parshad S, Yadav SP, Arora B. Urethral hemangioma. An unusual cause of hematuria. Urol Int. 2001;66:43-5.