Systemic treatment for coexisting mucinous urethral adenocarcinoma and prostate adenocarcinoma. Issue 6 (2nd August 2020)

• Record Type: Journal Article
• Authors: Nezu, Kunihisa; Okubo, Teppei; Shiraiwa, Manabu; Nozawa, Yoshihiro; Kyan, Atsushi
• Is Part Of: IJU case reports. Volume 3:Issue 6(2020)
• Page Start: 261
• Page End: 264
• Publication Date: 2020-08-02
• Subjects: adenocarcinoma -- carcinosarcoma -- epithelial‐mesenchymal transition -- prostate -- urethral neoplasms; Urology -- Periodicals; Genitourinary organs -- Periodicals; Electronic journals; Periodicals; 616.6
• DOI: 10.1002/iju5.12210
• Languages: English
• ISSNs: 2577-171X

Abstract

Abstract : Introduction: Mucinous urethral adenocarcinoma is a rare and progressive cancer of the prostatic urethra. Reports on palliative systemic treatment for mucinous urethral adenocarcinoma are few. We present a case of coexisting mucinous urethral and prostate adenocarcinomas managed with systemic treatment. Case presentation: A 66‐year‐old man presented with gross hematuria and urinary retention. Prostate‐specific antigen level was elevated, at 99 ng/mL, and prostate biopsy revealed moderately to poorly differentiated adenocarcinoma. Hormone therapy and standard chemotherapy for prostate adenocarcinoma were ineffective. Prostate re‐biopsy revealed coexisting mucinous urethral and prostate adenocarcinomas. Gemcitabine + cisplatin chemotherapy and folinic acid + 5‐fluorouracil + irinotecan chemotherapy temporarily suppressed the cancer, but 14 months after presentation, he developed liver metastasis and died. Autopsy revealed metastasis of both mucinous urethral adenocarcinoma and carcinosarcoma. Conclusion: Mucinous urethral adenocarcinoma is difficult to diagnose in coexistence with prostate adenocarcinoma. This was an extremely rare case showing chemoresistance due to epithelial‐mesenchymal transition.