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

TL;DR

A rare case of bladder cancer spreading to the prostate without affecting the prostatic urethra is reported, highlighting the need for precise diagnosis and early treatment.

Contribution

This case report documents a rare metastasis pattern of bladder cancer to the prostate without prostatic urethra involvement.

Findings

Bladder carcinoma in situ metastasized to the prostate but not the prostatic urethra.

Radical cystoprostatectomy and adjuvant chemotherapy improved patient prognosis.

Early diagnosis and treatment are crucial for managing such rare metastasis patterns.

Abstract

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.

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.

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.

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