Prostatic Ductal Adenocarcinoma-A Rare Entity With Radiological Dilemma Demanding Endoscopic Biopsy

This is a rare case of a prostatic ductal adenocarcinoma. A 75-year-old gentleman presented with complaints of lower urinary tract symptoms, constipation, and occasional hematuria. The clinical and radiological differentiations from other retroperitoneal soft cystic lesion were difficult, and fine needle aspiration cytology from the papillary solid components of the cyst was required to reach diagnosis. Transrectal ultrasound-guided biopsy was performed in view of the raised serum prostate-specific antigen (>100 ng/mL); however, the cyst was ruptured without yielding any tissue for biopsy. In such difficult situations, a cystourethroscopic view, biopsy of the cyst, and immunohistochemical analysis can help in diagnosing and confirming the prostatic ductal adenocarcinoma.