BACKGROUND Primary urethral cancer is exceedingly rare, resulting in a limitation in clinicians' experience, and an accurate diagnosis is often delayed due to the non-specific clinical presentation. Here, we present this case report to show the treatment of a patient with primary urethral cancer. Our patient was diagnosed as having primary urethral cancer in the First Clinical Hospital of Yichang by cystoscopy and biopsy. Due to her age, poor physical tolerance, and economic condition, she refused radical operation. Since there is no definite guideline for the treatment process of primary urethral cancer in clinics, operation methods and postoperative adjuvant treatments vary in different hospitals, leading to diverse prognostic effects. CASE PRESENTATION An 88-year-old Asian woman had difficulty in urinating for more than 6 months and the syndrome was aggravated for 1 month. She chose a relatively conservative treatment plan: primary tumor resection combined with bladder perfusion chemotherapy. Postoperative pathology revealed "urethra" high-grade urothelial carcinoma (sarcoma-like variants) with extensive necrosis. After treatment with intravesical chemotherapeutic drug (hydroxycamptothecin 40 mg), she was eventually released from our hospital in a stable condition. Postoperation follow-up was performed to observe to what extent this conservative treatment plan improved the quality of life and overall survival time of our patient. CONCLUSIONS She needed radical resection according to the actual situation. However, her age restricted her tolerance to general anesthesia; relatively conservative treatment options are available to ensure a high quality of life. The treatment of primary tumor resection combined with bladder perfusion chemotherapy is feasible. This case highlights the importance of the dissemination of new cases and optimizing primary urethral cancer diagnosis to obtain an effective treatment.

中文翻译：

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晚期原发性尿道癌：一例报告。

背景技术原发性尿道癌极为罕见，导致临床医生经验有限，并且由于非特异性的临床表现，准确的诊断常常被延迟。在这里，我们提供此病例报告以显示对原发性尿道癌患者的治疗。本患者经膀胱镜和活检被诊断为宜昌市第一临床医院原发性尿道癌。由于年龄大，身体耐受力差和经济状况，她拒绝进行激进手术。由于在临床上对原发性尿道癌的治疗过程没有明确的指导方针，因此不同医院的手术方法和术后辅助治疗方法也有所不同，从而导致不同的预后效果。病例介绍一名88岁的亚裔妇女排尿困难超过6个月，并且该综合征加重了1个月。她选择了一个相对保守的治疗方案：原发肿瘤切除结合膀胱灌注化疗。术后病理显示“尿道”高级别尿路上皮癌（肉瘤样变体）广泛坏死。经膀胱内化疗药物（羟基喜树碱40毫克）治疗后，她最终以稳定的状态从我们医院被释放。术后进行了随访，以观察这种保守的治疗计划在多大程度上改善了患者的生活质量和总体生存时间。结论她需要根据实际情况行根治性切除术。然而，她的年龄限制了她对全身麻醉的耐受性；相对保守的治疗选择可确保高质量的生活。原发肿瘤切除结合膀胱灌注化疗的治疗方法是可行的。该病例突出了传播新病例和优化原发性尿道癌诊断以获得有效治疗的重要性。