[Prostatic cancer with cystic formation: a case report]

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Prostate cancer can present with diverse imaging findings, including cystic formations, which are uncommon.
• Advanced prostate adenocarcinoma requires comprehensive diagnostic evaluation and tailored treatment strategies.

Observation:

• An 82-year-old male presented with a large hypogastric cystic mass (14x10x15 cm) and significantly elevated prostate-specific antigen (PSA) of 903 ng/ml.
• Pelvic CT and MRI revealed a complex cystic mass, while prostate biopsy confirmed moderately differentiated adenocarcinoma.
• Bone scintigraphy indicated metastatic involvement in the costa; however, the exact origin of the large anterior mass was initially uncertain.

Findings:

• Hormonal therapy, including luteinizing hormone-releasing hormone (LHRH) agonist and diethylstilbestrol, was initiated due to the patient's age.
• After 28 weeks of treatment, the patient showed a marked reduction in tumor size and normalization of PSA levels.

Implications:

• This case highlights the importance of considering prostate cancer in the differential diagnosis of large cystic masses, even with atypical presentations.
• Effective management of advanced prostate cancer with cystic features can be achieved with appropriate hormonal therapy.
• Reviewing similar cases in the literature aids in understanding and managing rare presentations of prostatic adenocarcinoma.