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Honda S, Kawahara T, Tanaka R, Yuguchi S, Yamanaka S, Fujii S, Hasizume A, Osaka K, Mimura N, Karibe J, Noguchi T, Shimokihara K, Takamoto D, Takeshima T, Teranishi JI, Makiyama K, Uemura H. Prostate ductal adenocarcinoma exhibiting a late recurrence in the anterior urethra 13 years post-total prostatectomy: a case report. J Med Case Rep 2024; 18:371. [PMID: 39152479 PMCID: PMC11330126 DOI: 10.1186/s13256-024-04699-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 07/12/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Prostate ductal adenocarcinoma, a rare histology observed in 0.4-0.8% of all prostate cancers, is treated similarly to acinar adenocarcinoma but tends to have a higher likelihood of metastasis, recurrence, and poorer prognosis. CASE PRESENTATION A 73-year-old Asian-Japanese male presented with gross hematuria, with investigations revealing a prostate ductal adenocarcinoma. Subsequent radical prostatectomy indicated a Gleason score of 8 with no lymph node metastasis. Despite initial prostate-specific antigen level reductions post-prostatectomy and salvage radiation therapy due to recurring elevated prostate-specific antigen levels, no recurrence was evident until 13 years later. A tumor in the anterior urethra was identified as metastasis of his prostate ductal adenocarcinoma. CONCLUSION This report presents an uncommon case of prostate ductal adenocarcinoma exhibiting a late recurrence in the anterior urethra 13 years post-radical prostatectomy.
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Affiliation(s)
- Seiichiro Honda
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.
| | - Reiko Tanaka
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shu Yuguchi
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Satoshi Fujii
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akihito Hasizume
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Kimito Osaka
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Noboru Mimura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Jurii Karibe
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeaki Noguchi
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Kota Shimokihara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Daiji Takamoto
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Teppei Takeshima
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Jun-Ichi Teranishi
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuhide Makiyama
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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Ananthapadmanabhan S, Williams Z, Wang H, Combes A, Wong V, Thangasamy I. Prostate cancer recurrence in the urethra with low PSA. Urol Case Rep 2024; 55:102787. [PMID: 39071853 PMCID: PMC11279688 DOI: 10.1016/j.eucr.2024.102787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024] Open
Abstract
When localised prostate cancer recurs after treatment, it occurs predictably in sites such as the prostatic bed, pelvic lymph nodes, spine, lung, and liver. Urethral metastasis of prostate cancer is exceedingly rare. We report a case of urethral recurrence of prostate cancer presenting as new lower urinary tract symptoms in an 82-year-old male 10 years after robotic radical prostatectomy with a very low PSA level of 0.05μg/L. This rare case highlights the need to maintain a degree of suspicion for prostate cancer recurrence in patients with a late onset of or changing lower urinary tract symptoms after radical prostatectomy.
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Affiliation(s)
| | - Zoe Williams
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, 2747, Australia
| | - Henry Wang
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, 2747, Australia
| | - Alexander Combes
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, 2747, Australia
| | - Veronica Wong
- Department of Nuclear Medicine and PET, Nepean Hospital, Kingswood, New South Wales, 2747, Australia
| | - Isaac Thangasamy
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, 2747, Australia
- University of Sydney, Faculty of Medicine, Sydney, New South Wales, Australia
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Evbuomwan O, Endres W, Tebeila T, Engelbrecht G. Atypical Presentation of Metastatic Castrate-resistant Prostate Cancer in a Middle Aged African Male with Good Response to Radioligand Therapy. Mol Imaging Radionucl Ther 2024; 33:57-62. [PMID: 38390823 PMCID: PMC10899738 DOI: 10.4274/mirt.galenos.2023.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Prostate cancer typically follows a characteristic pattern of metastatic spread to the pelvic lymph nodes and bone. Atypical patterns of metastasis are rare but have been documented. In African men, this disease tends to follow a more aggressive course, with the possibility of an atypical site of metastatic spread. We present a case of a 58-year- old African male with metastatic castrate-resistant prostate cancer who presented with both typical and atypical patterns of metastatic disease detected by a fluorine 18 prostate-specific membrane antigen positron emission tomography/computed tomography scan. This patient also had a good response to radioligand therapy.
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Affiliation(s)
- Osayande Evbuomwan
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Walter Endres
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Tebatso Tebeila
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Gerrit Engelbrecht
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
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Fujiwara S, Ishida M, Arai E, Baba Y, Anno T, Kobayashi H, Miyazaki Y. Isolated recurrence of prostate cancer to the anterior urethra 5 years after radiation therapy. IJU Case Rep 2022; 5:58-61. [PMID: 35005476 PMCID: PMC8720727 DOI: 10.1002/iju5.12394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Primary or metastatic urethral tumors are extremely rare. However, treatment strategies differ between primary and metastatic tumors. Therefore, establishing an accurate diagnosis is critically needed for initiating timely and appropriate therapy. CASE PRESENTATION We describe the case of a 79-year-old man with prostate cancer treated with radiotherapy and androgen deprivation therapy. He presented with macroscopic hematuria as a symptom of anterior urethral tumor at follow-up. Endoscopic tumor resection was performed. Hematoxylin and eosin staining showed adenocarcinoma component. Immunohistochemical staining revealed presence of metastatic prostate cancer to the urethra. CONCLUSION Regarding urethral tumors diagnosis, urologists should consider the possibility of metastasis from prostate cancer and perform immunohistochemical examination for establishing accurate diagnosis. Furthermore, if androgen deprivation therapy fails to suppress symptoms, radiotherapy or urethrectomy might be considered.
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Affiliation(s)
| | - Masaru Ishida
- Department of Urology Saiseikai Yokohamashi Tobu Hospital Kanagawa Japan
| | - Eri Arai
- Department of Pathology Keio University School of Medicine Tokyo Japan
| | - Yuto Baba
- Department of Urology Saiseikai Yokohamashi Tobu Hospital Kanagawa Japan
| | - Tadatsugu Anno
- Department of Urology Saiseikai Yokohamashi Tobu Hospital Kanagawa Japan
| | - Hiroaki Kobayashi
- Department of Urology Saiseikai Yokohamashi Tobu Hospital Kanagawa Japan
| | - Yasumasa Miyazaki
- Department of Urology Saiseikai Yokohamashi Tobu Hospital Kanagawa Japan
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