A 72-year-old man with the chief complaint of macrohematuria was referred to our hospital in February 1996. On transrectal examination, the prostate was stony hard without nodules. Cystoscopic findings and biopsies did not confirm a transitional cell carcinoma or carcinoma in situ in the bladder. However transurethral and transrectal biopsy specimens of prostate showed transitional cell carcinoma invading the prostate stroma. Pelvic CT scan revealed a lymph node metastasis in the left iliac artery region. Under the diagnosis of primary transitional cell carcinoma of the prostate, radical cystoprostatectomy and lymph node dissection were performed after two courses of neoadjuvant systemic chemotherapy. Pathologically no viable transitional cell carcinoma could be found in any of the specimens. Thus neo-adjuvant systemic chemotherapy was very effective in this case.
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