Primary resection of oligometastatic recurrent prostatic carcinoma in the urethra. Issue 9 (21st September 2022)

• Record Type: Journal Article
• Authors: Foo, Malia Alexandra; Lim, Ee Jean; Cheng, Christopher Wai Sam; Ng, Lay Guat
• Is Part Of: BMJ case reports. Volume 15:Issue 9(2022)
• Publication Date: 2022-09-21
• Subjects: urology -- urological surgery -- prostate cancer -- hematuria; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2022-250200
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A man in his 70s presented to the emergency department with acute urinary retention following a 2-day history of gross haematuria with blood clots. He had a significant medical history of intermediate-risk prostate adenocarcinoma (grade group 2, prostate-specific antigen (PSA) 14.9 ng/mL) for which he underwent a robotic-assisted laparoscopic radical prostatectomy (RARP) 13 years ago. PSA nadir was achieved (<0.03 ng/mL). Three years after RARP, he had biochemical recurrence with PSA rising to 0.06 ng/mL. Salvage radiotherapy was performed with good PSA response back to nadir. Workup for gross haematuria included a flexible cystoscopy which revealed a lobulated fleshy lesion occupying the mid-penile urethra. Staging imaging showed no local recurrence at prostatectomy site or lymphadenopathy. PSA was 4.2 ng/mL. Surgical resection with primary repair of the urethra was performed. Postoperative recovery was good with PSA achieving nadir. Histology revealed an upgraded metastatic prostate adenocarcinoma, grade group 5.