Primary Urothelial Carcinoma of the Prostate with Glandular Differentiation: A Case Report

A 53-year-old man presented to our department with acute urinary retention and an approximate 8-year history of frequent urination, dysuria, poor urinary stream and nocturia. His prostate-specific antigen (PSA) values were normal (<4 ng/ml) upon repeated testing. The patient was diagnosed with benign prostatic hyperplasia, although there was no significant improvement in his symptoms after treatment with oral finasteride and doxazosin. He then underwent transurethral resection of the prostate in February 2013, and histopathological examination showed adenocarcinoma of the prostate. His treatment regimen included daily oral bicalutamide and subcutaneous injection of Zoladex once per month. Three months later, radical prostatectomy was performed, and a prostate histopathological examination indicated primary urothelial carcinoma with glandular differentiation. His PSA values were normal (<4 ng/ml) before and after the radical prostatectomy. After the second operation, the patient received chemotherapy with gemcitabine and cisplatin. Two months later, magnetic resonance imaging (MRI) indicated local tumor recurrence. The patient was treated with chemotherapy combined with radiotherapy for 2 months, and subsequent MRI results showed that the recurrent tumor volume was significantly reduced. As a result, radiotherapy was stopped. The patient remains alive, and his general condition has clearly improved.