Prostatic and urothelial metastasis in the same lymph node: A case report

Elena Pacella, Francesco Ricci, Maurizio Colecchia, Francesco Boccardo, Antonio Lopez-Beltran, Bruno Spina

Research output: Contribution to journalArticlepeer-review


Background: Collision metastasis is a rare phenomenon in which metastases of carcinoma from 2 separate primary tumors occur in the same lymph node. We summarize here the clinical course and highlight the histological challenges in the diagnosis of this rare phenomenon. Case: A biopsy performed due to gross hematuria by endoscopic resection revealed an infiltrative high-grade urothelial carcinoma in a 75-year-old man receiving androgen deprivation therapy due to biopsy-proven high-grade prostate cancer. A radical cystectomy, with regional lymphadenectomy and prostatectomy, was performed. Three nodes appeared to have metastatic foci from both primary tumors: prostatic and urothelial cancer. The presence of the 2 tumor types colliding in the same lymph nodes was confirmed by immunohistochemical stains. Conclusion: In a patient with simultaneous tumors it is important to remember that a part of lymph node metastases with histological polymorphic appearance may result from a collision metastasis. In light of the important therapeutic consequences, a differential diagnosis is needed, suggesting appropriate immunohistochemical investigations.

Original languageEnglish
Pages (from-to)139-143
Number of pages5
JournalAnalytical and Quantitative Cytology and Histology
Issue number2
Publication statusPublished - 2015


  • Bladder cancer
  • Collision metastasis
  • Histological features
  • Immunohistochemistry
  • Lymph

ASJC Scopus subject areas

  • Anatomy
  • Histology
  • Medicine(all)

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