Solitary fibrous tumour mimicking a urethral caruncle: a diagnostic pitfall

The urethral caruncle is the most common lesion arising from the posterior lip of the urethral meatus in women; however, various benign and malignant tumours may mimic this condition. We report a case of a solitary fibrous tumour (SFT) presenting as a urethral caruncle. A woman in her late 60s presented with a progressively enlarging urethral mass that was accompanied by urinary spraying. Physical examination revealed a smooth spherical mass measuring 1.2 cm at the posterior urethral meatus. The lesion was completely excised under local anaesthesia. Histologically, the tumour consisted of spindle cells within collagenous stroma. Immunohistochemically, the tumour cells showed nuclear expression of STAT6 with focal CD34 positivity, supporting the diagnosis of SFT. No recurrence was observed during the 9-month follow-up period. This case highlights that lesions clinically resembling urethral caruncle may include mesenchymal tumours such as SFT, underscoring the importance of histopathological evaluation.