Initial Diagnosis and Detection of Very Late Local Recurrence of a Ductal Prostate Cancer due to a Ureteral Stone

Abstract EN

We report the case of a 74-year-old patient in whom a ductal prostate cancer was incidentally endoscopically diagnosed in the course of ureteral stenting due to a left distal ureteral stone.

The initial PSA was 0.8 μg/l and the digital rectal examination was not suspicious.

A radical prostatectomy was performed, and the ensuing follow-up was unremarkable with no signs of recurrence.

Fourteen years later, the patient presented with an obstructive pyelonephritis due to a left-sided ureteral stone requiring ureteral stenting.

An exophytic tumor was seen in the lining of vesicourethral anastomosis and surgically excised after the pyelonephritis subsided.

The histopathological and immunohistochemical analysis revealed a ductal cancer of the prostate consistent with a late local recurrence.

Serum PSA was below the limit of detection.

Re-staging performed by an MRI of the pelvis, thoracoabdominal CT scan, and gallium-68 PSMA-PET did not reveal any other signs of disease.

The ensuing follow-up is planned with regular flexible cystoscopy and computed thoracoabdominopelvic CT scans.