An Unusual Case of Synchronous Metastatic Urothelial Carcinoma and Prostatic Adenocarcinoma
Year: 2012
Type: conference-abstract
Abstract: The concurrence of urothelial carcinoma of the bladder with prostatic adenocarcinoma has been documented. However, the existence of synchronous metastatic carcinoma of the bladder and the prostate in the same lymph node has not been reported. We encountered a case of this rare clinicopathologic entity in an 83-year-old man who presented with increasing pelvic pain after an initial transurethral resection (TUR) of a high-grade bladder tumor and a negative metastatic computed tomography (CT) chest, abdomen, and pelvic scan workup. A radical cystoprostatectomy was subsequently performed, revealing a multicentric, high-grade, ill-defined, infiltrating urothelial carcinoma (9 × 7 cm) infiltrating the right pericystic soft tissue (pT3N2Mx). Histopathologic examination of the prostate revealed a multicentric adenocarcinoma (Gleason 4 + 4) involving 2 lymph nodes (pT3aN1Mx). Interestingly, while the right pelvic lymph node was positive for metastatic prostatic adenocarcinoma alone, immunohistochemical studies of the left pelvic lymph node revealed a dual metastatic urothelial (cytokeratin [CK]7 and pan-CK positive, prostate-specific antigen [PSA] and CK20 negative) and prostatic (PSA and pan-CK positive, CK7 and CK20 negative) carcinoma. The concomitance of metastatic urothelial carcinoma and prostatic adenocarcinoma is unusual, and their biologic behavior remains uncertain. A high index of suspicion along with thorough clinical examination, periodic assessment of PSA, and transurethral biopsies of the prostate and bladder may be warranted for an early diagnosis of this rare entity.
Authors: Tapan Bhavsar, Jun Liu, Yajue Huang
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2566899488