A Case of Prostatic Ductal Carcinoma spread to the Rectal Submucosa with an Atypical Clinical Course

Haruko Takuwa, Kenji Takemoto, Naoki Yokoo, Katsutaro Yasuda, Koji Kitamura, Takanobu Shigeta, Kazuma Yunoki, Masamichi Enya¹⁾, Shinichiro Yamada²⁾ and Kiyonao Okamoto³⁾

Department of Surgery, Department of Medicine¹⁾, Department of Urology²⁾ and Department of Pathology³⁾, Takayama Red Cross Hospital

We report a case of prostatic ductal carcinoma with an atypical clinical course. A 72-year-old man undergoing hormone therapy, surgical castration, and radiotherapy for prostate carcinoma in October 1997 reported rectal bleeding, and was found in December 2005 to have a tumor and a narrowed rectum, diagnosed in endoscopic ultrasonography as prostate cancer lymph node recurrence. For the intestinal tract disorder, we constructed an artificial double-barrelled sigmoid colon anus. Bleeding from a rectal tumor, however, necessitated a Hartmann operation in August, due to ductal carcinoma similar to the biopsy specimen from the 1997 operation. We diagnosed rectal submucousal change as due to metastasis of the prostate ductal carcinoma, because staining closely resembled that for the prostate biopsy specimen. PSA was in the normal range throughout. In prostatic ductal carcinoma, we must consider possible metastasis or recurrence, even if PSA is low.

Key words
metastasis to the rectal submucosa, prostatic ductal carcinoma

Reprint requests
Haruko Takuwa Department of Breast Surgery, Graduate School of Medicine, Kyoto University Hospital, Kyoto University
54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JAPAN

Accepted
September 24, 2008

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