Introduction: Prostate cancer is the third leading cause of death from cancer among American men. Acinar adenocarcinoma is the most common form of prostate cancer; however, there are several nonacinar adenocarcinoma variants, such as transitional cell carcinoma of the prostate and ductal adenocarcinoma. Materials and Methods: A retrospective cohort study was conducted on all Saudi patients diagnosed with adenocarcinoma of the prostate with transitional cell features. The data was collected from the Saudi Cancer Registry, which collects tumor data from all private, military, and Health Ministry hospitals in Saudi Arabia through five regional offices. Results: Out of 3608 patients, only 16 (0.44%) had adenocarcinoma with transitional cell features. All the tumors under investigation were malignant and constituted. Only 6.2% of the tumors were well-differentiated, 43.8% were moderately differentiated, and 50.0% were poorly differentiated. Among the included patients, 56.3% of the patients (n=9) died. There were no significant factors associated with death among patients, including the demographic and tumor-related variables. Conclusion: To the authors’ knowledge, this is the first study describing the prevalence of adenocarcinoma with transitional cell features and its characteristics in Saudi Arabia. The authors have demonstrated that this rare subtype may be more prevalent than what was originally believed. It is necessary for future studies to assess the effectiveness of various treatment modalities to combat it. Furthermore, identifying risk factors – if any – may be crucial in the prevention of its development among men worldwide.
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