Advanced ductal adenocarcinoma of the prostate in a 71-year old male: A case report and literature review

Abstract

Ductal adenocarcinoma of the prostate is extremely rare and it accounts for the prevalence of only 0.4% to 0.8% of all the prostate cancers compared to over 95% of the acinar type of adenocarcinoma. It has a poorer prognosis than the acinar type because of developing in the periurethral areas thus, making digital rectal examination and even prostate-specific antigen (PSA) to be normal. Herein the case of a 71-year old male of African origin without a prior diagnosis of prostate cancer was diagnosed with advanced stage ductal adenocarcinoma of the prostate. The pre-treatment PSA was 14.2 ng/ml with urine incontinency, macrohaematuria and haemoglobin level of 7.0 mg/dl. He was confirmed to have stage IV ductal adenocarcinoma of the prostate with Gleason score 8 (4 + 4).The patient described in this paper shares clinical presentation, PSA and digital rectal examination findings almost similar to other cases diagnosed with ductal adenocarcinoma that have been reported in the literature. Patients with ductal adenocarcinoma are at a high risk of having poor prognosis because of having negative screening results for digital rectal examination and PSA which usually help to prompt the process of diagnosis.

Keywords

• Ductal adenocarcinoma
• Prostate
• Poor prognosis