We report the case of a 74-year-old patient in whom a ductal prostate cancer was incidentally endoscopically diagnosed in the course of ureteral stenting due to a left distal ureteral stone. The initial PSA was 0. 8 μg/l and the digital rectal examination was not suspicious. A radical prostatectomy was performed, and the ensuing follow-up was unremarkable with no signs of recurrence. Fourteen years later, the patient presented with an obstructive pyelonephritis due to a left-sided ureteral stone requiring ureteral stenting. An exophytic tumor was seen in the lining of vesicourethral anastomosis and surgically excised after the pyelonephritis subsided. The histopathological and immunohistochemical analysis revealed a ductal cancer of the prostate consistent with a late local recurrence. Serum PSA was below the limit of detection. Re-staging performed by an MRI of the pelvis, thoracoabdominal CT scan, and gallium-68 PSMA-PET did not reveal any other signs of disease. The ensuing follow-up is planned with regular flexible cystoscopy and computed thoracoabdominopelvic CT scans.
Case reports in urology. 2020 Feb 18*** epublish ***
Manolis Pratsinis, Charlotte Düwel, Olivia Köhle, Annette Enzler-Tschudy, Hans-Peter Schmid, Patrick Betschart
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Department of Urology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany., Department of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.