Kosin Med J.  2016 Jun;31(1):66-70. 10.7180/kmj.2016.31.1.66.

Metachronous anterior urethral metastasis of prostatic ductal adenocarcinoma

• Oh JH
• Kim TS
• Rhew HY
• Chun BK

• KMID: 2328719
• DOI: http://doi.org/10.7180/kmj.2016.31.1.66

Abstract

Prostate cancer is increasing in frequency in Korea. Among them, ductal adenocarcinoma (DCP) has a more aggressive and poor prognosis than acinar adenocarcinoma (ACP), despite its low incidence. Patients usually present with symptoms of lower urinary tract symptoms and hematuria due to increasing tumor mass within the lumen of the prostatic urethra, making diagnosis of DCP by the transrectal prostate biopsy difficult. DCP is often metastasized at the time of diagnosis. DCP is transferable to most other organs but the metastasis to the anterior urethra is rare. There is no doubt that localized DCP requires radical prostatectomy (RP) but the guidelines for adjuvant therapy after RP have not yet been established. Methods of the treatment are confounded by individual differences, and arriving at a consensus is challenging due to insufficient data. We report a case of DCP and urethral metastasis after RP, thus aiding in the determination of treatment guidelines.

Keyword

Adenocarcinoma; Hematuria; Prostate cancer; Prostatectomy; Urethra

MeSH Terms

Adenocarcinoma*
Biopsy
Consensus
Diagnosis
Hematuria
Humans
Incidence
Individuality
Korea
Lower Urinary Tract Symptoms
Neoplasm Metastasis*
Prognosis
Prostate
Prostatectomy
Prostatic Neoplasms
Urethra

Figure

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  Fig. 1. Prostatic ductal adenocarcinoma Expanding and infiltrating adenocarcinoma is composed of tall columnar cells with abundant amphophilic cytoplasm, pseudostratified arrangement of nuclei and prominent or visible nucleoli.(H-E stain, x12, x40, x400)

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  Fig. 2A. The mass in the urethra was showed a papillary shape by cystoscopy.

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  Fig. 2B. The papillary urethral mass was removed by the trans urethral resection.

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  Fig. 3. Urethral ductal adenocarcinoma This polypoid ductal adenocarcinoma shows large large glands lined by tall pseudostratified columnar cells (H-E stain, x12, x200, x400)

Reference

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