MACROSCOPIC HEMATURIA AS AN INITIAL MANIFESTATION OF CARCINOMA OF THE COLON

Abstract

Secondary neoplasms of the prostate are rare and usually diagnosed at autopsy.' The primary tumor is most commonly of hematological origin or it emanates from an adjacent organ.2 A number of cases have been reported in which the primary tumor was diagnosed after the discovery of metastasis to the prostate. We report an unusual case of previously unknown colon cancer of which the initial manifestation was hematuria due to prostatic metastasis. CASE REPORT An 82-year-old man was hospitalized due to macroscopic hematuria. History was significant for transurethral prostatectomy 3 years previously with benign histology. Physical examination demonstrated a hard and nodular prostate. Serum prostate specific antigen was 3 ng./ml. (normal less than 4). Cystoscopy showed an irregular prostatic urethra and urine cytology revealed malignant adenoid type cells. The patient underwent transurethral prostatectomy. Histopathological evaluation showed well differentiated mucin producing adenocarcinoma that was probably metastatic from the colon. Staining was positive for carcinoembryonic antigen and negative for prostatic acid phosphatase (see figure). Colonoscopy showed 2 polypoid tumors in the right colon that were histologically diagnosed as well differentiated adenocarcinoma of the colon.