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Review
. 2019 Apr 23;19(1):374.
doi: 10.1186/s12885-019-5573-9.

Prostate cancer solitary metastasis to anal canal: case report and review of literature

Audrius Dulskas  1   2   3 , Vaidas Cereska  4 , Edvardas Zurauskas  5 , Eugenijus Stratilatovas  4 , Feliksas Jankevicius  6
Affiliations
Review

Prostate cancer solitary metastasis to anal canal: case report and review of literature

Audrius Dulskas et al. BMC Cancer. .

Abstract

Background: Here we present the first cases of prostate cancer solitary metastasis to anal canal.

Case presentation: A 67-year-old male patient underwent radical prostatectomy with ilio-obturator lymphonodectomy in 2016 due to poorly differentiated ductal adenocarcinoma (Gleason 4 + 5(40%) = 9) pT3bN0. Two months later increasing PSA rate was noted and the patient started adjuvant intermittent androgen deprivation therapy combined with radiotherapy. Year after patient was admitted to the hospital complaining of dyschezia, pain in anal canal, and bloody stool. Digital rectal examination revealed an anal fissure with ulceration. A biopsy from ulcerated area showed poorly differentiated ductal adenocarcinoma of the prostate. Because there was no evidence of distant metastases on abdominal computed tomography (CT) scan and pelvic magnetic nuclear resonance imaging (MRI) and the only metastasis was in anal canal patient underwent laparoscopic abdominoperineal resection (APR). Postoperative course was uneventful and patient was discharged at postoperative day 7.

Conclusions: Our presented case is the first to describe prostate cancer solitary metastasis to anal canal and we always have to be aware of possible rare disease while assessing the patient with rectal bleeding. Biopsy most of the time is the only and the most reliable test to differentiate between the diseases.

Keywords: Abdominoperineal excision; Case report; Metastatic anal canal tumour; Prostate cancer; Prostate cancer metastasis; Solitary metastasis.

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Conflict of interest statement

Ethics approval and consent to participate

Institutional review board of National Cancer Institute approval number 2018.05.01.

Consent for publication

Consent was signed by the patient for all the images, other personal and clinical details.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
T2 transversal view. Slightly enlarged left rectum wall with a slight increase of contrast. Accumulation (red arrow)
Fig. 2
Fig. 2
H&Ex100. Carcinoma of prostate show bowel muscular wall invasion by irregular malignant glands with enlarged nuclei, prominent nucleoli and dark cytoplasm
Fig. 3
Fig. 3
PSAx100. Malignant glands are positive for prostate specific antigen (PSA)
Fig. 4
Fig. 4
NKX3.1 × 100. Malignant glands are positive for NKX3.1
Fig. 5
Fig. 5
CKHMWx100. Malignant glands are positive for CKHMW
Fig. 6
Fig. 6
CK7x100. Malignant glands are negative for CK7
Fig. 7
Fig. 7
p63x100. Malignant glands are negative for p63
Fig. 8
Fig. 8
CDX2x100. Malignant glands are negative for CDX2
Fig. 9
Fig. 9
CK20x100. Malignant glands ar negative for CK20
See this image and copyright information in PMC

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