OBJECTIVETo investigate the mechanism and management of multiple urethral metastases from prostate adenocarcinoma after radical prostatectomy.

METHODSWe summed up the experience in the management of a case of multiple urethral metastases from prostate adenocarcinoma after radical prostatectomy and reviewed relevant literature. The patient was a 79-year-old male, who had received radical prostatectomy for prostate adenocarcinoma 13 years before, and presented with macrohematuria and dysuria in the past 2 weeks. A nodule (1.0 x 0.5 cm) was found in the urethral meatus. Cystourethroscopy revealed multiple tumors in the urethra and biopsy indicated them to be metastases from prostate adenocarcinoma. The preoperative level of PSA was 3.01 microg/L. As treatment, we performed radical urethrectomy and cystostomy.

RESULTSPostoperative pathology showed multiple metastases of prostate adenocarcinoma to the urethra, involving the urethral sphincter and corpus spongiosum. Immunohistochemistry revealed PSA (+), PsAP(+), AR(+) and CK 7(-). The surgical margin was negative. The patient recovered well postoperatively, with a PSA level of 1.00 microg/L.

CONCLUSIONUrethral metastasis of prostate adenocarcinoma after radical prostatectomy is rarely seen clinically. For the treatment of multiple urethral metastases, surgery is the first choice and radical urethrectomy is an appropriate management.