A 69 year-old man was admitted with urinary urgency and hematuria.  Previously diagnosed prostatic adenocarcinoma (Gleason Grade 4 + 3; T3b, N1, Stage IV) had been treated two years earlier with radical prostatectomy and postoperative hormonal therapy; the patient has since been clinically recurrence free with no serologically detectable PSA.  Cystoscopy performed following the present admission demonstrated an ulcerated invasive tumor, consistent with a bladder primary.  Transurethral resection was performed. 

The TURBT specimen was comprised of multiple fragments of extensively myo-invasive tumor without an intact overlying urothelial surface.  The histologic composition was monomorphous, the appearance uniform from area to area, and the following immunohistochemical results obtained:  synaptophysin (shown), chromogranin A and pankeratin, positive; CK7, CK20, PSA, and PSAP, negative.

A Tumor of the Prostate

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