Mucinous Adenocarcinoma of the Prostate With Normal Prostate-Specific Antigen Levels, Pulmonary Metastasis, and the Absence of Nodal Disease: A Case Report.

Autor:	Khokhar AA; Urology Department, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, GBR., Howles SA; Urology Department, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, GBR., Leiblich AW; Urology Department, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, GBR., Samdani K; Surgery Department, Benazir Bhutto Hospital, Rawalpindi, PAK., Ahmed M; Medicine Department, Isfandyar Bukhari District Hospital, Attock, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Mar 20; Vol. 16 (3), pp. e56563. Date of Electronic Publication: 2024 Mar 20 (Print Publication: 2024).
DOI:	10.7759/cureus.56563
Abstrakt:	A 74-year-old man was suffering from nine months of perineal pain and progressive worsening of urinary symptoms including nocturia and urgency. His prostate-specific antigen (PSA) levels were 1.48 ng/mL at the time of referral. Initially, a differential diagnosis of prostatitis or seminal vesicle inflammation was made, and four weeks of antibiotics were prescribed, which were later extended to six weeks due to failure of symptoms to resolve. Magnetic resonance imaging (MRI) of the prostate was then conducted. The impression was that there was ejaculatory duct obstruction caused by enlarged seminal vesicles with no evidence of significant prostate cancer. The prostate-specific antigen density (PSAd) was 0.04, and the prostate imaging reporting and data system (PIRADS) score was I-II. A CT chest with contrast was conducted for further investigation of pulmonary nodules found on the CT urogram. It revealed multiple calcified pulmonary nodules which were suspicious of malignancy. A CT-guided biopsy of one of the pulmonary nodules was taken, and histopathological analysis revealed a mucinous adenocarcinoma. A transurethral resection of the prostate (TURP) was then performed. Histopathological analysis of the prostatic surgical specimen revealed invasive mucinous adenocarcinoma. Based on the findings, a diagnosis of mucinous adenocarcinoma of the prostate with atypical lung metastasis without osseous or regional lymph node involvement was made, stage T4 N0 M1a. The patient is currently on a treatment regimen consisting of carboplatin, pemetrexed, and pembrolizumab. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Khokhar et al.)
Databáze:	MEDLINE
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