The probability of involvement of human papillomavirus in the carcinogenesis of bladder small cell carcinoma, prostatic ductal adenocarcinoma, and penile squamous cell carcinoma: a case report

BACKGROUND: Human papillomavirus is associated with urogenital carcinogenesis such as penile and uterine cervix cancer. On the other hand, association between human papillomavirus infection and risk of bladder and prostatic cancer remains controversial. CASE PRESENTATION: We report a rare case of a 67-year-old Japanese man with synchronous triple urogenital cancer including bladder small cell carcinoma, prostatic ductal adenocarcinoma, and penile squamous cell carcinoma, who presented with a history of asymptomatic gross hematuria. Bladder small cell carcinoma and prostatic ductal adenocarcinoma were diagnosed by histopathological examination after transurethral resection of the tumor. Moreover, he was diagnosed with penile carcinoma based on the exfoliative cytodiagnosis of nodular and papillary tumors inside the preputial collar. He was treated with laparoscopic radical cystectomy, urethrectomy, partial penectomy with pelvic lymph node dissection, and ileal conduit urinary diversion. To identify a common pathogenesis, we considered human papillomavirus as an etiologic factor because it is a known risk factor for penile carcinoma. Human papillomavirus deoxyribonucleic acid bands were detected by polymerase chain reaction in the three tumors. There was a possibility that human papillomavirus was involved in the carcinogenesis of the triple cancer. CONCLUSIONS: To the best of our knowledge, this is the first report of the synchronous triple urogenital cancer of small cell carcinoma of the bladder, ductal adenocarcinoma of the prostate and penile squamous cell carcinoma. We believe that human papillomavirus may have been involved in the carcinogenesis of the triple urogenital cancer described in this case.