title: An 82-year-old Caucasian man with a ductal prostate adenocarcinoma with unusual cystoscopic appearance: a case report.
abstract: BACKGROUND
  Ductal adenocarcinoma is a rare variety of the common acinar adenocarcinoma. It usually presents with refractory symptoms, and during cystoscopy, it is seen as an exophytic lesion at the area of the verumontanum.
  
  
  METHODS
  An 82-year-old Caucasian man was diagnosed with ductal adenocarcinoma of the prostate after undergoing transurethral resection of the prostate for urinary retention. Immunohistochemistry confirmed the nature of the tumor. The patient was treated with triptorelin, 3.75 mg once/month, and bicalutamide, 50 mg 1 × 1. The serum prostate-specific antigen at three, six and 12 months after transurethral resection of the prostate was 0.1 ng/ml. The patient remains asymptomatic, and he entered a six-month follow-up protocol.
  
  
  CONCLUSIONS
  Ductal adenocarcinoma often involves the central ducts of the gland and may present as an exophytic papillary lesion in the prostatic urethra. This is why it usually presents with refractory symptoms. The outcome for men with prostatic ductal adenocarcinoma is, in most studies, worse than the outcome for men with prostatic acinar adenocarcinoma. Aggressive management is indicated, even with low-volume metastatic disease.
authors.affiliation: Department of Urology, Athens University Medical School-LAIKO Hospital, (Agiou Thoma), Athens (11527), Greece. katafigiotis@yahoo.com.
authors.forename: Stavros
authors.initials: S
authors.lastname: Sfoungaristos
authors.forename: Ioannis S
authors.initials: IS
authors.lastname: Katafigiotis
authors.forename: Stavros I
authors.initials: SI
authors.lastname: Tyritzis
authors.forename: Adamantios
authors.initials: A
authors.lastname: Kavouras
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kanatas
authors.forename: Anastasios
authors.initials: A
authors.lastname: Petas