CASE PRESENTATION: We report here a case of urothelial-type
adenocarcinoma arising from the prostatic urethra. The patient is an 81 year-old man with a history of pT1 urothelial cell
carcinoma of the bladder status post trans-urethral resection of
bladder tumor (TURBT) who initially presented with irritative
lower urinary tract symptoms and mucosuria refractory to
Flomax and
finasteride. A shared decision was made for the patient to undergo trans-urethral resection of prostate (
TURP). At the time of surgery, a papillary
tumor emanating from the prostatic urethra was found and no urothelial lesions were noted in the bladder. Pathology of the resected prostatic chips revealed an invasive
adenocarcinoma with intestinal-type differentiation that stained positive for CK7, CK20, and
villin, but negative for PSA, PSAP,
uroplakin, and CDX-2. Colonoscopy was normal and CT scan did not show any evidence of colonic lesions nor visceral or
lymph node metastases. Thus, the patient was diagnosed with a primary urothelial-type
adenocarcinoma of the prostatic urethra.
CONCLUSION: Herein we review the literature regarding this unusual entity, and discuss the differential diagnosis, immunohistochemistry, and the importance of correctly identifying this rare
tumor.