原発性前立腺移行上皮癌の1例

Abstract

A 58-year-old man was admitted to our hospital with the complaint of pollakisuria and micturitional pain. The urine cytology showed malignant cells suggesting the urothelial cancer, but various examinations could not reveal the malignant lesion. The prostate was also normal by the digital examination, endoscopy, roentgenography, ultrasonography and serum markers, and the transperineal prostate biopsy showed no malignancy. Three years after the first admission the prostate showed slight hardness and the transperineal biopsy suggested adenocarcinoma of the prostate. Hormonal therapy was then started and the prostate showed no remarkable change until about two years later, when rapid progression of the prostatic tumor was recognized. The transperineal biopsy of the prostate revealed the transitional cell carcinoma with negative staining of Alcian-Blue, PAS and PSA (prostate specific antigen). The epithelia of the bladder and posterior urethra were normal. The radical cystoprostatectomy was done and the histological diagnosis was the pure type of primary transitional cell carcinoma of the prostate. The literatures were reviewed and the clinical differentiation between transitional cell carcinoma and adenocarcinoma of the prostate was discussed.