A case of cystic prostate cancer with urinary retention treated by transrectal needle aspiration of the cyst

A 76-year-old Japanese man presented with a complaint of urinary retention. On digital rectal examination, a cystic prostate with a hard elastic mass was palpated. The serum concentration of prostate specific antigen (PSA) was elevated to 1,585 ng/ml. Multidetector-row helical computed tomography revealed a huge cystic tumor with solid lesion occupying the pelvic cavity. Transrectal needle biopsy demonstrated moderately differentiated adenocarcinoma of the prostate and simultaneous aspiration of the cyst yielded old-bloody fluid of 526 ml, which brought a significant improvement of urination. With a clinical diagnosis of prostate cancer (T4N0 M0) with cyst formation, anti-androgen therapy with a luteinizing hormone relaeasing hormone analogue and flutamide significantly lowered the serum PSA to normal level and the tumor was reduced in volume. This is the 70th case of prostate cancer with cyst formation reported in Japan.