Prostate cancer recurrence mimicking invasive urothelial cancer of the bladder

Residual Prostatic Tissue Mimics Anterior Wall Carcinoma of the Bladder: A Rare Complication of the Holmium Laser Enucleation of the Prostate (HoLEP)

The holmium laser enucleation of the prostate (HoLEP) is a widely accepted and reliable treatment for benign prostatic hyperplasias. In developing countries where HoLEP surgery has only recently been introduced, its popularity is steadily increasing. In our case, the patient's history of HoLEP and the image of the irregular mass extending from the anterior bladder wall into the lumen were initially misdiagnosed as bladder cancer. In our review of the English literature, we were not able to find any cases similar to ours, in which the residual prostatic tissue following a HoLEP mimicked a bladder cancer.

Adenocarcinoma in ectopic prostatic tissue at the trigone of urinary bladder

Introduction

Ectopic prostatic tissue is prostatic tissue located distant from the prostate gland. Although its existence is not uncommon, the occurrence of adenocarcinoma in ectopic prostatic tissue is rare.

Case presentation

A 68-year-old man was suspected to have a nodular-type tumor in the bladder trigone and a tumor in the prostate based on magnetic resonance imaging and cystoscopy results. Transurethral tumor resection and transrectal prostate needle biopsy revealed the coexistence of ectopic prostatic adenocarcinoma in the bladder trigone and low-risk orthotopic prostate cancer. Four years later, the tumor evolved to intermediate-risk prostate cancer during active surveillance, and the patient underwent prostatectomy with resection of the bladder trigone. Pathology indicated no residual ectopic prostatic tissue or adenocarcinoma at the bladder trigone.

Conclusion

Adenocarcinoma in ectopic prostatic tissue is very rare; however, when found, the possibility of concurrent cancer in the prostate gland should be considered.

Prostate cancer metastasis mimicking a primary urothelial carcinoma of the bladder

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.