A high-grade undifferentiated prostate malignancy in a young male suggestive of male adnexal tumour of Wolffian origin - A rare case and diagnostic challenge

Rowan Klein Nulend; Kathleen Lockhart; Kevin Tree; Linh Nk Tran; Bashar Matti; Yelise Foon; Ali Moghimi; Daniel Wong; Jordan Butler; Lawrence Hc Kim; Audrey Wang; Manish I Patel

doi:10.1016/j.eucr.2026.103359

A high-grade undifferentiated prostate malignancy in a young male suggestive of male adnexal tumour of Wolffian origin - A rare case and diagnostic challenge

Urol Case Rep. 2026 Jan 27:65:103359. doi: 10.1016/j.eucr.2026.103359. eCollection 2026 Mar.

Authors

Rowan Klein Nulend^{1

2}, Kathleen Lockhart¹, Kevin Tree¹, Linh Nk Tran¹, Bashar Matti¹, Yelise Foon¹, Ali Moghimi¹, Daniel Wong¹, Jordan Butler¹, Lawrence Hc Kim^{1

2}, Audrey Wang^{1

2}, Manish I Patel^{1

2}

Affiliations

¹ Westmead Hospital, Sydney, NSW, 2145, Australia.
² University of Sydney, Sydney, NSW, 2050, Australia.

Abstract

We report a rare case of a high-grade, poorly differentiated prostatic malignancy in a 24-year-old, initially presenting with haematuria and urinary retention following trauma. Imaging and cystoscopy revealed a large prostate mass. Although a final histopathological diagnosis could not be definitively determined, expert review suggests this may resemble a male adnexal tumour of Wolffian origin, an extremely rare pathology. The patient underwent neoadjuvant chemotherapy, followed by radical cystoprostatectomy and adjuvant radiotherapy. He remains in remission 18 months post-treatment. This case underscores the importance of thorough investigation and multidisciplinary management of rare, aggressive prostatic tumours in young patients.

Keywords: Mesonephric tumour; Prostate cancer; Youth and adolescent cancer.

Publication types

Case Reports