فهرست نشریات علمی دسترسی آزاد ایران

Introduction: Prostatic ductal adenocarcinoma (DAC) is a rare and aggressive variant of prostate cancer that can present clinical features mimicking other malignancies, such as transitional cell carcinoma (TCC). This case highlights the diagnostic challenges and the importance of distinguishing DAC from TCC due to differing treatment approaches and prognoses.Case Presentation: An 80-year-old man presented with hematuria and mild lower urinary tract symptoms. A digital rectal examination revealed a mildly enlarged, rubbery prostate, and his prostate-specific antigen (PSA) level was 2 ng/ml (normal range: 0–4 ng/ml). Cystoscopy identified a lesion at the verumontanum suggestive of TCC. However, histopathological analysis of biopsy specimens revealed high-grade DAC of the prostate with cribriform and papillary architecture. Immunohistochemical staining was positive for prostate-specific acid phosphatase (PSAP) and PSA, confirming the diagnosis. Imaging studies, including a bone scan, pelvic MRI, and CT of the thorax, abdomen, and pelvis, showed no evidence of localized or metastatic disease. The patient underwent transurethral resection (TUR) of the transitional zone and verumontanum, with histopathology reporting no carcinoma infiltration.Conclusions: This case emphasizes the need for thorough diagnostic evaluation in patients presenting with lesions suggestive of TCC, as DAC may present similarly but requires distinct management. Early and accurate diagnosis can significantly impact treatment strategies and clinical outcomes.