Multiple primary prostate cancer.

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• The existence of endometrial carcinoma of prostatic origin remains controversial.
• Prostate cancer can present as multiple primary tumors, including rare subtypes like endometrial (utricular) and papillary carcinoma.
• Understanding the association between different prostate cancer subtypes is crucial for diagnosis and treatment.

Observation:

• Two cases of multiple primary prostate tumors are presented.
• Case 1: Endometrial (utricular) carcinoma simultaneously associated with microacinar carcinoma and a history of transitional carcinoma of the urinary bladder.
• Case 2: Papillary carcinoma with associated microacinar carcinoma, demonstrating a significant response of the papillary component to chemotherapy.

Findings:

• The first case represents the twelfth reported instance of endometrial (utricular) carcinoma with coexisting microacinar carcinoma and a prior transitional cell carcinoma.
• The second case highlights papillary prostate cancer with pulmonary metastasis, elevated estrogen levels that normalized post-treatment, and a dramatic chemotherapeutic response.
• These findings suggest distinct biological behaviors and potential therapeutic vulnerabilities within multiple primary prostate tumors.

Implications:

• This report contributes to the understanding of rare prostatic malignancies and their complex presentations.
• The dramatic response to chemotherapy in one case suggests potential targeted treatment strategies for papillary prostate cancer.
• Further research is warranted to elucidate the pathogenesis and optimal management of multiple primary prostate tumors, including endometrial (utricular) carcinoma.