A case of prostatic adenocarcinoma recurrence presenting as ductal carcinoma of the prostate

Nature Clinical Practice. Urology
William H TuJoseph C Liao

Abstract

A 61-year-old man with a history of recurrent prostate cancer presented with obstructive urinary symptoms. He had been diagnosed with locally invasive adenocarcinoma of the prostate 10 years previously and treated with neoadjuvant hormonal and external beam radiation therapies. Because of the patient's rising PSA level, he had been started on goserelin 6 years after this diagnosis and bicalutamide 6 months before the current presentation. The patient presented to the urology clinic with worsening lower urinary tract symptoms consisting of nocturia, urgency, and weak stream. Physical examination revealed a largely normal digital rectal examination, although there was slight asymmetry. The post-void residual urine volume was approximately 200 ml. Laboratory tests showed no evidence of urinary tract infection, but confirmed a rising PSA level despite low serum testosterone levels. Cystoscopic examination revealed hypervascular, large lateral prostatic lobes obstructing the bladder neck. The bladder was normal. The patient underwent transurethral resection of the prostate. Soon after the resection started, bilateral papillary tumors arising from the stroma of both prostatic lobes were uncovered. Owing to the diffuse nature of the p...Continue Reading

References

Apr 15, 1991·Cancer·W N ChristensenJ I Epstein
Aug 1, 1985·The American Journal of Surgical Pathology·D G BostwickR V Rouse
Sep 19, 2006·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Charles C Guo, Jonathan I Epstein

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Citations

Jun 15, 2010·Clinical Oncology : a Journal of the Royal College of Radiologists·C PatersonJ M Russell

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