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Case Reports
. 2024 Jun 15;24(1):127.
doi: 10.1186/s12894-024-01516-6.

Carcinoma in situ within the bladder trigone with an isolated metastasis to the prostate without involvement of prostatic urethra: a unique case report

Omran Batha #  1 , Ahmed Aldolly #  2 , Yousef Alsaffaf  3 , Suaad Hamsho  4 , Mohammad Atia  5 , Fayez Salmeh  1 , Louei Alia  1
Affiliations
Case Reports

Carcinoma in situ within the bladder trigone with an isolated metastasis to the prostate without involvement of prostatic urethra: a unique case report

Omran Batha et al. BMC Urol. .

Abstract

Background: Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can spread through blood and lymphatic circulation to distant parts of the body.

Case presentation: A 58-year-old non-smoker male presented with gross and microscopic hematuria. His family history included his father's recent bladder cancer. Initial investigations showed hematuria, inflammation, negative urine culture, digital rectal examination revealed an enlarged right lobe of the prostate, and an elevated Prostate-Specific Antigen level. Histopathological examination of samples taken from the bladder mucosa and the prostate confirmed urothelial carcinoma in situ in the bladder and prostate. Further evaluation revealed no other metastasis. The tumor was classified as T4aN0M0. The patient underwent radical cystoprostatectomy and histopathological examination showed that the tumor invading the muscularis propria of the bladder as well as the prostatic glands, but no malignancy was found in prostatic urethra and other areas. The patient was discharged three weeks post-operation and completed on adjuvant chemotherapy consisting of Gemcitabine, and Cisplatin to prevent of relapse. The patient is currently in a good healthy.

Conclusion: The occurrence of bladder cancer metastasizing to the prostate without involving the prostatic urethra is uncommon and requires precise diagnostic techniques for accurate tumor classification. Early management is advised to enhance the prognosis for the patient.

Keywords: Bladder; Carcinoma in Situ; Case Report; Metastasis; Prostate; Prostatic Urethra.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prostate biopsy revealed high-grade carcinoma in prostatic ducts, immunohistochemical staining resulted in negative NKX3.1 and positive Gata3 markers, indicative of a primary urothelial origin of the cancer
Fig. 2
Fig. 2
(A) The cystoscopy revealed edematous bladder mucosa with red areas and minor bleeding from the prostate. No visual signs of malignancy were observed. (B) The cystoscopy revealed normal appearance of the prostatic urethra during visual examination
Fig. 3
Fig. 3
MRI revealed (A) a lesion exhibiting high signal intensity on T1-weighted images within the right peripheral zone of the prostate. This finding suggests the presence of a possible tumor or hemorrhage, which could be a post-biopsy complication. (B, C) A slight thickening of the bladder wall mucosa was observed post-injection, suggesting potential inflammatory or neoplastic alterations
Fig. 4
Fig. 4
Microscopic examination of prostate glandular tissue showed neoplastic cells (high grade nuclear features: nuclear pleomorphism, hyperchromatic, high N/C ratio with frequent mitotic figures) arranged in irregular nests and invading the prostatic stroma and glands
See this image and copyright information in PMC

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