Advanced carcinoma of the prostatic urethra in a patient with marked response to chemotherapy, leading to preservation of the bladder

Int J Clin Oncol. 2010 Feb;15(1):109-11. doi: 10.1007/s10147-009-0006-4. Epub 2010 Jan 20.

Abstract

We performed transurethral resection of the prostate (TUR-P) for a 66-year-old man with benign prostatic hyperplasia. Pathological examination diagnosed poorly differentiated urothelial carcinoma of the urethra with broad prostatic permeation. Random bladder biopsies showed no malignancy, but a second TUR-P revealed urothelial carcinoma in the prostate and bladder neck. Computed tomography (CT) showed lymph node metastases from para-aortic to right/left external iliac and left obturator nodes, so clinical stage T3N2M0 carcinoma of the prostatic urethra was diagnosed. Given the presence of lymph node metastases, neoadjuvant chemotherapy using cisplatin 70 mg/m(2), ifosfamide 1.2 g/m(2) and docetaxel 70 mg/m(2) (PIT) was considered. After chemotherapy, CT showed complete response (CR) of all lymph nodes. Local control in the bladder was considered to be good, so total prostatectomy and retroperitoneal lymph node dissection was selected instead of total cystoprostatectomy. Pathological findings of surgical specimens showed no residual carcinoma in the prostatic urethra or lymph nodes, although prostatic adenocarcinoma was recognized. No recurrences or metastases have been encountered as of 3 years and 5 months since surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Neoadjuvant Therapy
  • Prostatectomy
  • Prostatic Hyperplasia / surgery
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / secondary*
  • Prostatic Neoplasms / surgery
  • Urethral Neoplasms / drug therapy*
  • Urethral Neoplasms / pathology
  • Urethral Neoplasms / surgery