Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2024; 12(26): 5952-5959
Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5952
Concurrent occurrence of adenocarcinoma and urothelial carcinoma of the prostate gland: A case report
Jhe Yuan Hsu, Yi Sheng Lin, Li Hua Huang, Tang Yi Tsao, Chao Yu Hsu, Yen Chuan Ou, Min Che Tung
Jhe Yuan Hsu, Yi Sheng Lin, Li Hua Huang, Chao Yu Hsu, Yen Chuan Ou, Min Che Tung, Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
Tang Yi Tsao, Department of Pathology, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
Author contributions: Hsu JY, Lin YS, Huang LH, and Tsao TY contributed to patient care, data collection, and manuscript writing and editing; Hsu CY, Ou YC, and Tung MC contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Sheng Lin, MD, Chief Doctor, Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, No. 699 Section 8, Taiwan Boulevard, Wuqi District, Taichung 435403, Taiwan. tung12197@gmail.com
Received: February 25, 2024
Revised: June 15, 2024
Accepted: July 15, 2024
Published online: September 16, 2024
Processing time: 146 Days and 5 Hours
Abstract
BACKGROUND

Adenocarcinoma is the most common subtype of prostate cancer. Prostatic urothelial carcinoma (UC) typically originates from the prostatic urethra. The concurrent occurrence of adenocarcinoma and UC of the prostate gland is uncommon.

CASE SUMMARY

We present the case of an 82-year-old male patient with simultaneous adenocarcinoma and UC of the prostate gland. The patient underwent a transrectal ultrasound-guided biopsy, and the pathology test revealed UC. Subsequently, transurethral laser prostatectomy was performed, and the pathology test indicated adenocarcinoma of the prostate with a Gleason score of 3 + 4 and high-grade UC. Therefore, the patient was treated with androgen deprivation therapy, systemic chemotherapy, and immunotherapy. Magnetic resonance imaging performed during follow-up revealed a prostate tumor classified as cT2cN1M0, stage IVA. Therefore, the patient underwent robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissection. The final pathology test of the prostate gland revealed acinar-type adenocarcinoma, Gleason pattern 4 + 3, pT2N0M0, and high-grade UC. The patient regularly presented to the clinic for postoperative follow-up evaluations. He did not experience any urinary discomfort.

CONCLUSION

According to our literature review, this is the first reported case of coexisting adenocarcinoma and UC of the prostate gland.

Keywords: Adenocarcinoma, Urothelial carcinoma, Prostate, Coexist, Case report

Core Tip: This report of synchronous adenocarcinoma and urothelial carcinoma (UC) of the prostate gland describes the unique prostate cancer manifestations in a male patient as well as the clinical journey from his initial symptoms of urinary retention and gross hematuria to the final treatment comprising robotic-assisted radical prostatectomy and bilateral pelvic lymph nodes dissection. This rare co-occurrence of two distinct cancer subtypes of the prostate gland without a history of UC of the urinary bladder and evident recurrence after treatment emphasizes the need for heightened diagnostic awareness and suggests novel oncogenic pathways and genetic predispositions.