Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5952
Revised: June 15, 2024
Accepted: July 15, 2024
Published online: September 16, 2024
Processing time: 146 Days and 5 Hours
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.
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.
According to our literature review, this is the first reported case of coexisting adenocarcinoma and UC of the prostate gland.
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.