Metastatic Mucinous Adenocarcinoma of the Prostate with PSA Value of 8.6 ng/mL at 5-Year-Followup after Prostatectomy, Radiotherapy, and Androgen Deprivation

Christos Kalaitzis,Michael Koukourakis,Stilianos Giannakopoulos,Efthimios Sivridis,Alexandra Giatromanolaki,Stavros Touloupidis,Athanasios Bantis

doi:10.1155/2014/218628

Christos Kalaitzis, Michael Koukourakis + Show 5 more

Open Access

https://doi.org/10.1155/2014/218628

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Abstract

Introduction. Mucinous adenocarcinoma of the prostate is a rare variant of prostate cancer. Its malignant potential and the clinical course of the affected patients remain, by and large, controversial. No data exist about the course of metastatic mucinous adenocarcinoma of the prostate. Case Presentation. This case report describes the excellent clinical course of a 68-year-old patient with metastatic mucinous adenocarcinoma of the prostate, treated by radical prostatectomy, irradiation, and androgen deprivation. Conclusion. In our case, mucinous adenocarcinoma of the prostate does not appear to behave differently than acinar prostate cancer. Its malignant potential is dependent on its Gleason score.

Highlights

Mucinous adenocarcinoma of the prostate is a rare variant of prostate cancer
We report the clinical course of a mucinous adenocarcinoma of the prostate with metastasis to iliac lymph nodes at a PSA value of 8.6 ng/mL treated by radical prostatectomy, followed by irradiation and androgen deprivation according to Vancouver protocol
A new CT abdominal scan revealed a mass of 5 cm diameter in the field of the left iliac junction, while the bone scan remained free of any metastatic involvement

Summary

Introduction

Mucinous adenocarcinoma of the prostate is one of the least common morphological variants of prostate cancer, defined by the presence of pools of extraluminal mucin involving at least 25% of the tumor volume at prostatectomy. We report the clinical course of a mucinous adenocarcinoma of the prostate with metastasis to iliac lymph nodes at a PSA value of 8.6 ng/mL treated by radical prostatectomy, followed by irradiation and androgen deprivation according to Vancouver protocol. A 68-year-old Caucasian man was admitted to hospital with a diagnosis of prostate cancer (Gleason score 4 + 3 = 7, PSA value 8.6 ng/mL), after taking a biopsy in an external urological surgery. Histopathological examination confirmed the presence of a prostatic adenocarcinoma with extraluminal mucinous pools involving >80% of the tumor volume. A new CT abdominal scan revealed a mass of 5 cm diameter in the field of the left iliac junction, while the bone scan remained free of any metastatic involvement. We stopped androgen deprivation therapy and measured PSA and testosterone value every 3 months. It is our plan to restart androgen deprivation therapy at PSA value of ≥2 ng/mL

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