Hsu Jhe Yuan, Lin Yi Sheng, Huang Li Hua, Tsao Tang Yi, Hsu Chao Yu, Ou Yen Chuan, Tung Min Che
Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan.
Department of Pathology, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan.
World J Clin Cases. 2024 Sep 16;12(26):5952-5959. doi: 10.12998/wjcc.v12.i26.5952.
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.
腺癌是前列腺癌最常见的亚型。前列腺尿路上皮癌（UC）通常起源于前列腺尿道。前列腺腺癌和UC同时发生的情况并不常见。
我们报告一例82岁男性患者，同时患有前列腺腺癌和UC。患者接受了经直肠超声引导下活检，病理检查显示为UC。随后，进行了经尿道激光前列腺切除术，病理检查显示前列腺腺癌，Gleason评分为3 + 4，高级别UC。因此，患者接受了雄激素剥夺治疗、全身化疗和免疫治疗。随访期间进行的磁共振成像显示前列腺肿瘤分类为cT2cN1M0，IV A期。因此，患者接受了机器人辅助根治性前列腺切除术和双侧盆腔淋巴结清扫术。前列腺最终病理检查显示为腺泡型腺癌，Gleason模式4 + 3，pT2N0M0，以及高级别UC。患者定期到诊所进行术后随访评估。他没有出现任何尿路不适症状。
根据我们的文献综述，这是首例报告的前列腺腺癌和UC并存的病例。
