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Mixed adenoneuroendocrine carcinoma of the urethra
  1. Nicholas Raison1,2,
  2. Ursula McGovern4,
  3. John Hines3 and
  4. Dimitrios Volanis1
  1. 1 Department of Urology, Royal Free London NHS Foundation Trust, London, UK
  2. 2 Division of Transplantation Immunology and Mucosal Biology, King’s College London, London, UK
  3. 3 Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
  4. 4 Department of Oncology, The Royal Free NHS Trust, London, UK
  1. Correspondence to Mr Nicholas Raison, nicholasraison{at}


Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour found predominantly in the gastrointestinal tract. Comprising adenocarcinomatous and neuroendocrine components, MANEC have been reported in the bladder. We report the first case to our knowledge of a MANEC arising in the urethra. A 62-year-old woman presented with a suburethral mass. Initial excision of the mass revealed it to be a MANEC. Immunohistochemistry staining was positive for CK20 and synaptophysin associated with neuroendocrine tumours. Cross-sectional imaging ruled out metastases and the patient underwent radical urethrectomy, vaginal reconstruction and Mitrofanoff urinary diversion. The patient declined adjuvant chemotherapy and remained under regular surveillance. MANECs are uncommon tumours and treatment was therefore guided by expert opinion. A multidisciplinary approach is essential with the early involvement of surgeons, oncologists, histopathologist, radiologist and neuroendocrine specialists.

  • urology
  • surgical oncology
  • urological cancer
  • chemotherapy
  • pathology

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  • Contributors NR: drafted the case report. DV: contributed to the conception of the work, critically revised the draft and gave final approval to the case report. UM and JH: contributed to critical revision and final approval of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient and public involvement Obtained.