A Case of Prostatic Cancer with Rectal Metastasis and Its Difficulty in Diagnosis

Makoto Kinouchi, Kenichi Shiiba*, Manabu Satou, Naoyuki Kaneko, Takashi Doi, Fusakuni Kuroda and Nobuyuki Kobayashi

Department of Surgery, Shirakawa Kousei General Hospital
Division of Biological Regulation and Oncology, Department of Surgery, Tohoku University Postgraduate School of Medicine*

A 75 years old man, who had undergone radical prostatectomy for prostatic cancer in 1996, was admitted to our hospital for difficulty in passing stools. His serum prostate specific antigen (PSA) level was elevated but the other laboratory data was within the normal range. A colonoscopy and barium enema study revealed an entire stricture in the upper rectum. The specimen from the rectal biopsy showed a poorly differentiated adenocarcinoma. Pelvic CT showed rectal wall thickness and a high-density mass near the urinary bladder far from the following stenosis. Therefore we diagnosed rectal cancer complicated with local recurrence of prostate cancer and we conducted an abdominoperineal resection of the rectum. Microscopic examination of the specimen revealed a poorly differentiated adenocarcinoma located mainly in the deeper part of rectal wall, but a few carcinomas were located in the mucosal layer. Because the tumor cells stained positively for PSA, we made a diagnosis of prostatic cancer with rectal metastasis. We herein report on a case of the prostatic cancer with rectal metastasis, with a review of the literature.

Key words
prostatic cancer, rectal metastasis, rectal stenosis

Reprint requests
Makoto Kinouchi Department of Surgery, Shirakawa Kousei General Hospital
114 Aza Yokomachi, Shirakawa, 961-0907 JAPAN

Accepted
May 25, 2005

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