Ureteric stricture: an unusual presentation of metastatic prostate adenocarcinoma

We describe an unusual case of a prostatic adenocarcinoma presenting with a ureteric stricture secondary to a discrete metastatic lesion. A 76-year-old man presented with a short history of right loin pain. Initial examination was unremarkable, digital rectal examination was normal and prostate specific antigen was within normal range. Computed tomography showed right hydronephrosis and a distal ureteric stricture. A distal ureteric transitional cell carcinoma was thought to be most likely. A nephroureterectomy was carried out and histology revealed a skipped lesion of a metastatic prostate adenocarcinoma. Metastatic lesions to the ureters due to prostate cancer are rare. It was believed to be secondary to a transitional cell carcinoma as there was no evidence initially to suggest prostatic disease as the cause. A prostatic adenocarcinoma should be considered in the differential diagnosis of any lesions in the ureter believed to have a malignant origin.

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The Incidental prostatic adenocarcinoma and transitional cell carcinoma involvement of the prostate gland in patients undergoing radical cystoprostatectomy for bladder cancer treatment in Rajavithi Hospital

Insight Urology ◽

10.52786/isu.a.31 ◽

2021 ◽

Vol 42 (2) ◽

pp. 103-109

Author(s):

Weerawut Promwattanapan ◽

◽

Nattapong Wongwattanasatien ◽

Keyword(s):

Bladder Cancer ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Prostate Gland ◽

Transitional Cell ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Prostatic Adenocarcinoma ◽

Pathological Findings ◽

Radical Cystoprostatectomy

Objective: To determine the incidence of incidental prostatic adenocarcinoma and transitional cell carcinoma (TCC) involvement of the prostate gland in patients undergoing radical cystoprostatectomy in Rajavithi Hospital, Secondly, to assess the possible influence of the patient factors and bladder cancer on the pathological findings of the prostate gland. Materials and Methods: We retrospectively reviewed 169 male patients who had undergone radical cystoprostatectomy for bladder cancer between April 2013 and August 2019. Pathologic findings of the prostate gland and urothelial cancer in the prostate gland were catalogued. Information including age, body mass index (BMI), underlying disease, glomerular filtration rate (GFR), pathologic stage, and grade was collected and analyzed to determine any correlations. Results: Incidental prostatic adenocarcinoma and TCC involvement of the prostate gland were found in 15 patients (8.9%) and 29 patients (17.2%), respectively. There were no correlations between patient demographics and pathological findings of the prostate gland. Conclusion: Although the incidence of incidental prostatic adenocarcinoma and TCC involvement of the prostate gland in our research is low, the screening of every candidate for prostate sparing cystectomy with a digital rectal examination, prostate-specific antigen, and transurethral biopsy of the prostatic urethra and bladder neck prior to surgery are recommended.

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Adenocarcinoma in Ectopic Prostatic Tissue at Dome of Bladder: A Case Report of a Patient With Urothelial Carcinoma of the Bladder and Adenocarcinoma of the Prostate

Archives of Pathology & Laboratory Medicine ◽

10.5858/2009-0338-cr.1 ◽

2010 ◽

Vol 134 (9) ◽

pp. 1271-1275 ◽

Cited By ~ 2

Author(s):

Jerad M. Gardner ◽

Hema Khurana ◽

Fredrick S. Leach ◽

Alberto G. Ayala ◽

Jim Zhai ◽

...

Keyword(s):

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Prostate Gland ◽

Transitional Cell ◽

Digital Rectal Examination ◽

Prostatic Adenocarcinoma ◽

Prostatic Tissue ◽

Low Grade ◽

Bladder Dome ◽

First Case

Abstract We report a case of ectopic prostate tissue with an associated prostatic adenocarcinoma occurring in the dome of the urinary bladder. A 62-year-old man presented with a 4-month history of persistent microscopic hematuria following a urinary tract infection. Other complaints included frequent urination, but there was neither dysuria nor gross hematuria. Digital rectal examination revealed a smooth prostate of normal size. Cystoscopic examination revealed a sessile lesion of the anterior bladder neck and multiple smaller papillary lesions throughout the bladder. Following a transurethral resection of the bladder tumor with a diagnosis of muscle-invasive transitional cell carcinoma grade 3, a radical cystoprostatectomy was performed. The diagnosis of transitional cell carcinoma was confirmed, but in addition, a different lesion was also incidentally found in the dome of the bladder. This incidental lesion showed a prostatic adenocarcinoma arising from ectopic prostatic tissue within the bladder submucosa. The prostate also showed prostatic adenocarcinoma, but this was minimal, low grade, and confined to the prostate gland, and thus it was felt to be unlikely to have metastasized to the bladder dome. Adenocarcinoma arising in ectopic prostatic tissue is a rare finding and to our knowledge only 1 case has been previously described, occurring in the soft tissue adjacent to the prostate. We report the first case of adenocarcinoma arising in ectopic prostatic tissue within the bladder.

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