Tubular adenomatous metaplasia (nephrogenic adenoma) of the female urethra.

We present a case of tubular adenomatous metaplasia (nephrogenic adenoma) arising within a urethral diverticulum in a woman complaining of a vaginal mass with dyspareunia. This lesion, which uncommonly affects the urethra, may clinically manifest as a gynecologic condition and mimic a low-grade adenocarcinoma on pathologic assessment. Criteria for diagnosis and current concepts of pathogenesis are discussed. Our findings, including an immunocytochemical work-up, support the concept of a reactive metaplastic response rather than nephrogenic differentiation.