Abstract
While histopathology remains the diagnostic gold standard for urothelial carcinoma, this case highlights the emerging role of advanced ultrasonographic techniques in characterizing urethral malignancies. We present a 51-year-old female with a one-month history of refractory lower urinary tract symptoms (urinary frequency, urgency, dysuria, and nocturia) unresponsive to conventional anti-inflammatory therapy. Multimodal ultrasonographic evaluation, incorporating conventional sonography, transrectal ultrasound, elastography, and contrast-enhanced ultrasonography (CEUS), revealed a complex proximal urethral mass with malignant features. Subsequent cystoscopic and histopathological examinations confirmed the diagnosis of primary urethral adenocarcinoma. This case underscores the diagnostic value of comprehensive ultrasound protocols in evaluating female urethral neoplasms.