Ductal Adenocarcinoma: A Rare Entity of Prostate Gland in a Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Patient

Abstract

Prostate cancer is the most common malignancy in men and ductal adenocarcinoma is a pathologic subtype with specific histological and clinical features. Seventy-six year-old male patient with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) admitted to our hospital with lower urinary tract symptoms. The last prostate specific antigen (PSA) level was 26 ng/ml and serial transrectal ultrasound guided biopsies were administered and benign prostate hyperplasia and non-specific prostatitis were the results of pathology reports. Due to the persistence of the symptoms transurethral resection of the prostate was performed. In the pathologic evaluation of the material adenocarcinoma focuses without stroma has been observed between the hyperplasic prostate tissues. The tumor has been diagnosed as ductal adenocarcinoma with 4 + 4 Gleason pattern score. Bone scintigraphy was revealed activity uptake on lomber vertebral column due to metastasis. Computerized tomography was revealed previous bilateral inguinal and right iliac lymphadenopathy due to CLL/SLL. Total androgen deprivation therapy and bilateral orchiectomy was applied. After three mounts according to biochemical and imaging results, radiotherapy cure began. Ductal adenocarcinoma is a rare subtype of prostate carcinoma with clinical behavior from that seen in conventional adenocarcinoma. On the other hand it is worth to point out the occurence of this entity as second malignancy during follow-up of CLL/SLL.