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Case Reports: Rare disease
Primary resection of oligometastatic recurrent prostatic carcinoma in the urethra
  1. Malia Alexandra Foo1,
  2. Ee Jean Lim2,
  3. Christopher Wai Sam Cheng2,3 and
  4. Lay Guat Ng2
  1. 1National University Singapore Yong Loo Lin School of Medicine, Singapore
  2. 2Urology, Singapore General Hospital, Singapore
  3. 3Urology, Sengkang General Hospital, Singapore
  1. Correspondence to Malia Alexandra Foo; maliafoo{at}u.nus.edu

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.

  • urology
  • urological surgery
  • prostate cancer
  • hematuria

https://doi.org/10.1136/bcr-2022-250200

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    Footnotes

    • Twitter @eejeanlim

    • Contributors MAF contributed by data analysis for the literature review and drafting of the article. EJL contributed to this article by drafting the article and revising the manuscript. CWSC and LGN contributed to the supervision and critical revision of important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.