Frontiers in medicine · 2026
A rare case of concurrent prostatic acinar adenocarcinoma and primary prostatic urothelial carcinoma: case report and literature review.
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Xia Yan, Deng Yamei
Аннотация
BACKGROUND: Acinar adenocarcinoma is the most common subtype of prostate cancer, while primary prostatic urothelial carcinoma is clinically rare. The composite tumor with both occurring simultaneously within the prostate is even rarer, with limited clinical reports and diagnostic and therapeutic experience available to date.
CASE PRESENTATION: This article reports a case of a 75-year-old male with concurrent prostatic acinar adenocarcinoma and primary prostatic urothelial carcinoma. The patient was admitted to the hospital due to an elevated prostate-specific antigen (PSA) level detected during physical examination for 2 years. Preoperative magnetic resonance imaging (MRI) showed a nodule in the left peripheral zone of the prostate, and radical prostatectomy was performed subsequently. Postoperative pathological diagnosis revealed prostatic acinar adenocarcinoma (Gleason score 4 + 3, pT3b stage) and primary prostatic urothelial carcinoma in situ with microinvasion (<0.1 cm). The patient received disitamab vedotin targeted therapy 6 months after surgery, and multi-point biopsy of the bladder mucosa 10 months after surgery showed no tumor tissue. At the time of this report, the patient had undergone 15 months of follow-up with no evidence of tumor recurrence.
CONCLUSION: The composite tumor of concurrent prostatic acinar adenocarcinoma and primary prostatic urothelial carcinoma is clinically rare. Definitive diagnosis requires comprehensive judgment based on imaging examinations, histopathological observation and immunohistochemical detection. Individualized treatment plans should be formulated based on multidisciplinary consultation, and long-term close follow-up of patients is necessary to monitor tumor recurrence.
CASE PRESENTATION: This article reports a case of a 75-year-old male with concurrent prostatic acinar adenocarcinoma and primary prostatic urothelial carcinoma. The patient was admitted to the hospital due to an elevated prostate-specific antigen (PSA) level detected during physical examination for 2 years. Preoperative magnetic resonance imaging (MRI) showed a nodule in the left peripheral zone of the prostate, and radical prostatectomy was performed subsequently. Postoperative pathological diagnosis revealed prostatic acinar adenocarcinoma (Gleason score 4 + 3, pT3b stage) and primary prostatic urothelial carcinoma in situ with microinvasion (<0.1 cm). The patient received disitamab vedotin targeted therapy 6 months after surgery, and multi-point biopsy of the bladder mucosa 10 months after surgery showed no tumor tissue. At the time of this report, the patient had undergone 15 months of follow-up with no evidence of tumor recurrence.
CONCLUSION: The composite tumor of concurrent prostatic acinar adenocarcinoma and primary prostatic urothelial carcinoma is clinically rare. Definitive diagnosis requires comprehensive judgment based on imaging examinations, histopathological observation and immunohistochemical detection. Individualized treatment plans should be formulated based on multidisciplinary consultation, and long-term close follow-up of patients is necessary to monitor tumor recurrence.