Prostate cancer metastasis mimicking a primary urothelial carcinoma of the bladder

Abstract

We report on a 79-year-old male patient who presented with asymptomatic elevation of prostate-specific antigen and a concurrent papillary lesion, which raised the suspicion of synchronous bladder and prostatic malignancies. He underwent a trans-perineal prostate biopsy as well as transurethral resection of bladder tumour, which revealed a Gleason 9 adenocarcinoma of prostatic origin. While synchronous bladder and prostate cancer is a possibility, differential diagnosis in a patient presenting with lesions of the bladder neck should include advanced prostate cancer.

Adenocarcinoma in ectopic prostatic tissue at the trigone of urinary bladder

“…When EPT develops adenocarcinoma, benign prostatic tissue surrounding cancer should be present, which can differentiate EPT adenocarcinoma from bladder metastases of PCa. Such bladder metastases are rare, with only 9 cases reported (Table 2 ) 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ; the metastases were identified on MRI or computed tomography at the time of diagnosis of metastatic PCa or PSA elevation after radical prostatectomy or during hormonal therapy. In all cases, primary bladder cancer was initially suspected, yet TURBT revealed bladder metastases from PCa.…”