Clear cell adenocarcinoma of the prostatic urethra: A case report

Abstract

Introduction Clear cell adenocarcinoma of the prostatic urethra in men is an extremely rare disease, with only eight case reports published. Case presentation A 56‐year‐old man visited our hospital for gross hematuria. Urinary cytology detected class V, cystoscopy showed no abnormal findings, and contrast‐enhanced computed tomography also showed no abnormal findings in his upper urinary tract except for a low‐enhancement lesion on his left prostate lobe. Magnetic resonance imaging revealed a cystic lesion surrounding the prostate that was suspected of being urethral or prostate cancer, so transurethral resection was performed. A papillary tumor was detected at the prostatic urethra, and after resecting this tumor, a cavity showing multiple tumors was observed. The final pathological diagnosis was clear cell adenocarcinoma. Laparoscopic radical cystectomy and urethrectomy were thus performed. The pathological diagnosis was the same as at the primary tumor site. Conclusion We herein report a case of clear cell adenocarcinoma of the prostatic urethra.

Clear cell adenocarcinoma of the prostatic urethra with metachronous prostate adenocarcinoma

“…In the only report describing endoscopic findings of CCA of the prostatic urethra, a diverticulum with multiple tumours was seen. 2 In our case, the tumours were exophytic in nature, covering the surface of the prostatic urethra. No cavity or diverticulum was uncovered during resection of the prostate.…”

“…Presenting symptoms for CCAU in males are most commonly gross haematuria (33%) and urinary retention (33%). 2 Mean age at diagnosis is 63 years (31–92 years). 5 It is an aggressive cancer with poor overall survival.…”

“…CCAU has been managed with urethrectomy, radical cystectomy, transurethral resection, radiotherapy, chemotherapy or observation with mixed results. 1 , 2 Hormone, targeted and immunotherapy have been used in isolated cases. 3 The majority (80%) of CCAU cases underwent operative intervention, most commonly anterior exenteration and pelvic lymph node dissection.…”

“… 1 It is exceedingly rare in the literature, with as few as 9 cases of CCAU reported to arise within the prostate or prostatic urethra. 2 , 3 …”

Primary clear cell adenocarcinoma of prostate

“…Most of the previous cases showed negative staining of PSA except one positive for PSA[ 10 ] and two showed positive for PAX-8. [ 4 12 ]…”