Urethral nodules are one of the symptoms of paraurethral adenocarcinoma. The early symptoms of paraurethral adenocarcinoma are difficulty in urination, bleeding from the urethra, frequent urination and painful urination. A nodular or red bleeding mass appears in the distal urethra or urethral orifice, and local swelling of the urethra can be palpable. When the tumor foci increase in size, they may obstruct the urethra or extend to the vulvar vestibule or vaginal orifice, with obvious ulcers, hemorrhagic masses with pain and possible metastases to the inguinal and pelvic lymph nodes. The etiology of paraurethral adenocarcinoma is not well understood. Some scholars believe that irritation of the urethra by urination, sexual intercourse, pregnancy or recurrent urinary tract infections may be a trigger for some urothelial carcinomas. Proliferative diseases such as sarcoidosis, papilloma, adenoma, and polyp can be secondary to malignant transformation. Leukoplakia of the urethral mucosa is considered to be a precancerous lesion. The diagnosis of urethral nodules can be made from the diagnosis of its primary disease. There are three main types of paraurethral adenocarcinoma: early stage paraurethral adenocarcinoma, middle stage paraurethral adenocarcinoma and advanced stage paraurethral adenocarcinoma, and the difficulty to make the diagnosis varies in different stages, the following is about the differential diagnosis of urethral nodules Early stage paraurethral adenocarcinoma should be distinguished from urethral caruncle, and biopsy should be done for any urethral caruncle with suspected malignancy to make a clear diagnosis. Intermediate and advanced paraurethral adenocarcinoma should be excluded whether the primary lesion is from the vestibule, but the former is adenocarcinoma and the latter is squamous cell carcinoma. The initial diagnosis of paraurethral adenocarcinoma can be made based on the clinical manifestations of symptoms and signs; the diagnosis can be confirmed when the biopsy of the urethral mass is adenocarcinoma. The time between the onset of symptoms and diagnosis may be days or years, usually 3-12 months, and in rare cases, patients may have no symptoms at all.