A rare case of prostatic malignancy

A 70-year-old male presented with refractory urinary retention 3 years back. He had undergone a prior trans urethral resection of prostate (TURP) 5 months back elsewhere. A revision TURP was done and the histopathology showed differentiated adenocarcinoma with cartilaginous and osseous metaplasia. Bone scan showed no evidence of metastasis. He underwent bilateral orchidectomy soon after. He presented with urinary retention 14 months later and underwent TURP. Hard prostatic tissue was resected and histopathology reports were same as previous report. Bone scan showed evidence of solitary metastasis in the second rib. MRI and CT scan showed re-growth. He had persisting lower urinary tract symptoms with hematuria. A palliative radiation was given which alleviated the urinary symptoms; patient refused radical cystoprostatectomy and currently is on conservative management.