This is an 84 year-old female who was seen by a urologist for a urethral mass. Mass was excised and clinically was thought to be a “urethral caruncle”.

Urethral Mass

Image 1-Low power magnification reveals a cellular neoplasm replacing
most of the submucosal tissue.


Image 2-The tumor is separated from the overlying transitional and
squamous mucosa.


Image 3

Image 4-Cytologically pleomorphic neoplasm with mitotic figures.

Image 5-Rare cells contain a faint brown pigmentation.

Additional Immunoperoxidase studies were performed:

CD45- NEGATIVE
CYTOKERATIN- NEGATIVE
CK7- NEGATIVE
CK20- NEGATIVE
HMB-45- POSITIVE
MAA- POSITIVE
VIMENTIN- POSITIVE
S-100- POSITIVE


What is your diagnosis?