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Ductal Adenocarcinoma of the Prostate Presenting With Bladder Invasion and Bone Metastasis: A Case Report.

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Cureus 📖 저널 OA 99.9% 2021: 42/43 OA 2022: 79/79 OA 2023: 181/181 OA 2024: 284/284 OA 2025: 774/774 OA 2026: 506/506 OA 2021~2026 2025 Vol.17(6) p. e86000
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Riddi VL, Harahap EU, Sitinjak D, Nirmawati R

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Ductal adenocarcinoma of the prostate (PDA) is a rare and aggressive variant of prostate cancer with a tendency for advanced local invasion and atypical metastatic spread.

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APA Riddi VL, Harahap EU, et al. (2025). Ductal Adenocarcinoma of the Prostate Presenting With Bladder Invasion and Bone Metastasis: A Case Report.. Cureus, 17(6), e86000. https://doi.org/10.7759/cureus.86000
MLA Riddi VL, et al.. "Ductal Adenocarcinoma of the Prostate Presenting With Bladder Invasion and Bone Metastasis: A Case Report.." Cureus, vol. 17, no. 6, 2025, pp. e86000.
PMID 40662003 ↗

Abstract

Ductal adenocarcinoma of the prostate (PDA) is a rare and aggressive variant of prostate cancer with a tendency for advanced local invasion and atypical metastatic spread. We report a case of a 54-year-old male presenting with urinary symptoms and significant weight loss. Imaging revealed a pelvic mass involving the prostate and bladder, with bone metastases to the pelvis and femur. Histopathological examination of transurethral resection specimens demonstrated ductal architecture. Immunohistochemistry showed α-Methylacyl-CoA racemase (AMACR) positivity, patchy cytokeratin 7 (CK7) expression, and negative prostate-specific antigen (PSA) and GATA-binding protein 3 (GATA3). Despite the unusual immunohistochemistry profile, the findings supported a diagnosis of PDA. The patient received radiotherapy and hormonal treatment, resulting in a marked PSA decline (PSA levels declined from 19.94 ng/mL to 0.34 ng/mL over eight months, representing a reduction of approximately 98.3%). This case highlights the diagnostic complexity of PDA, particularly when immunohistochemical findings deviate from classical patterns, and underscores the need for an integrated diagnostic approach in managing aggressive prostate cancer variants.

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