Abstract
BackgroundProstate cancer (PCa) originating from the prostate base may intrude into the urinary bladder and may be misdiagnosed as bladder cancer. In this retrospective study, we reviewed the clinic data on PCa cases which were initially misdiagnosed as bladder cancer in order to identify diagnostic methods that would allow a better differential diagnosis for PCa.MethodsOut of a total of 455 patients treated for PCa at our hospital between April 2003 and June 2011, 14 patients (3.1%) had been initially misdiagnosed as urinary bladder urothelial cell carcinoma. The clinical data on these 14 cases was retrieved and analyzed.ResultsOf the 14 patients, 11 patients were eventually diagnosed with PCa after MRI examination, and seven out of these had PCa with bladder neck invasion. Prostate needle biopsy or transurethral resection of prostate (TURP) revealed that all 14 patients had adenocarcinoma of prostate with Gleason scores ranging from 7 to 9. Nine patients received TURP for hematuria or lower urinary tract blockage. The mean follow-up was 37 months, during which six patients survived.ConclusionsAs clinical presentation and in emergency settings, prostate cancer originating from the prostate base can be confused with bladder cancer originating from the neck or the triangle region of the urinary bladder. Serum prostate specific antigen (PSA) levels and digital rectal examination, in combination with transrectal ultrasound (TRUS), MRI, and prostate needle biopsy are valuable tools for definitive differential diagnosis of the basal prostate cancer.
Highlights
Prostate cancer (PCa) originating from the prostate base may intrude into the urinary bladder and may be misdiagnosed as bladder cancer
In order to improve the clinical differential diagnosis of PCa from urinary bladder urothelial cell carcinoma, we reviewed and analyzed the clinical data of the misdiagnosed PCa cases
Clinical diagnostic methods Routine tests that had been performed on all patients were digital rectal examination (DRE), a blood test for prostate-specific antigen (PSA), prostate needle biopsy by the systemic 10-needle method, abdominal color Doppler, exfoliative urine cytology with acridine orange staining, and isotope emission computed tomography (ECT) bone scan
Summary
Prostate cancer (PCa) originating from the prostate base may intrude into the urinary bladder and may be misdiagnosed as bladder cancer. PCa which originates from the base of prostate may enlarge and protrude into the bladder and form a regional hunch in the neck, trigone and posterior wall of the bladder. This is normally seen as intra-bladder-protruding lumps on the coronal plane during image examination and could be clinically misdiagnosed as a bladder-occupying lesion
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