Prostatic Adenocarcinoma With Pseudocapsule

A 72-year-old man was referred to our hospital for treatment of prostatic adenocarcinoma with atypical imaging findings. The periprostatic mass was distinguishable from the prostate on magnetic resonance imaging, although the prostatic adenocarcinoma had been identified by needle biopsy at a previous hospital. To confirm the site of prostatic adenocarcinoma, transrectal ultrasonography-directed biopsy of the prostate and solitary mass was performed in our hospital. Diagnosis by re-biopsy revealed prostatic adenocarcinoma existing as a solitary mass. Radical prostatectomy was performed with no evidence of metastasis on imaging findings. Intraoperative findings revealed no adhesion between the prostate and pelvic floor. Pathological diagnosis revealed negative surgical margins, and a thin crust surrounding the adenocarcinoma. Strict pathological examination indicated a tiny adenocarcinoma existing within morphologically normal prostate tissue comprising nearly the entire mass. Based on these results, the final pathological diagnosis was locally advanced adenocarcinoma with pseudocapsule. In the present case, we concluded that a tiny prostatic adenocarcinoma had expanded in the lateral pelvic fascia, which formed a pseudocapsule. By 14 months postoperatively, prostate-specific antigen levels had decreased below the limit of detection. To the best of our knowledge, prostatic adenocarcinoma with pseudocapsule has not been described previously. doi: http://dx.doi.org/10.4021/wjnu76w