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A case of particular diffusion of prostate cancer

Un caso di diffusione neoplastica particolare di adenocarcinoma della prostata

Abstract

Neoplastic diffusion can occur due to dissemination, continuity, through lymphatic
or haematic vessels, or, more rarely originate from surgical instruments. We report
a particular case of prostate cancer spread.
A 64-year-old man was diagnosed with undifferentiated prostate cancer through prostate
biopsy. The patient was treated with a total androgenic block allowing a decrease in PSA
blood level. The patient, wishing to regain his sexual activity compromised by hormonal
therapy, interrupted the treatment spontaneously and unchecked. 19 months later he contacted
us again: we had to hospitalize him due to a 12-hour anuresis. A urgent right transcutaneous
nephrostomy was carried out, yielding an improvement in the patient's condition.
A descending pyelography carried out by means of nephrostomy revealed a completely
reduced urethral lumen. During the following surgery for transcutaneous urinary derivation
we observed the two ureters entangled in whitish tissue, spreading bilaterally up to the renal
pelvis. The histological examination of tissue samples showed the presence of neoplastic
metastasis of prostatic origin.
We assume that this neoplastic diffusion has occurred due to permeability through the lymphatic
vessels of the urethral wall, producing a subsequent neoplasm growth: this has been
limited by the urethral connective sheath, thus preventing its wide diffusion to the surrounding
tissues, but fostering its spreading upwards along the ureter pathway.

Urologia 2007; 74(2): 118 - 120

Article Type: CASE REPORT

Authors

M. Marzi, P. Piras, M. D'Alpaos, A. Paiusco, F. Marchesotti, M.S. Minervini

Article History

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