Metastatic Prostate Cancer in Bladder

This patient with prostate cancer (Gleason score 4+3=7) was treated with brachytherapy. Five years later, he presented with gross hematuria and a bladder mass. The left half of the bladder biopsy shows single tumor cells in the lamina propria which are reminiscent of plasmacytoid variant of urothelial carcinoma; however, they were strongly positive for PSA and PAP supporting prostatic origin. Adenocarcinoma in the right half of the image was negative for these markers.