{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:08:54Z","timestamp":1779455334651,"version":"3.53.1"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: The coexistence of synchronous urologic malignancies may present diagnostic and therapeutic challenges, particularly when symptoms are minimal or nonspecific. This case illustrates the role of multimodal diagnostic correlation in identifying a second primary urologic malignancy during the evaluation of incidental PSA elevation. Case presentation: Case Presentation: We report the case of a 56-year-old male presenting with minimal lower urinary tract symptoms who underwent stepwise diagnostic evaluation including PSA (prostate specific antigen), free PSA, urinary SelectMDx RT-PCR testing (reverse transcription polymerase chain reaction), multiparametric MRI (magnetic resonance imaging), transrectal biopsy and inflammatory biomarker assessment. PSA was 17.69 ng\/mL with a free PSA ratio of 6.56%. SelectMDx indicated a 90% probability of prostate cancer and a 65% risk of Gleason \u2265 7 disease. mpMRI demonstrated two suspicious lesions without extracapsular extension. Biopsy confirmed acinar adenocarcinoma Gleason 7 (3 + 4), Grade Group 2. Persistent post-biopsy hematuria led to additional imaging that revealed bladder wall thickening, and cystoscopy confirmed multifocal carcinoma in situ. Radical cystoprostatectomy with orthotopic ileal neobladder reconstruction was performed. Conclusions: This case illustrates the importance of diagnostic vigilance and multimodal correlation in a minimally symptomatic patient, particularly when persistent clinical findings are not fully explained by the initial diagnosis. The findings should be interpreted as illustrative and cannot be generalized beyond the single-case context.<\/jats:p>","DOI":"10.3390\/reports9020166","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:14:52Z","timestamp":1779452092000},"page":"166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Synchronous Prostate Adenocarcinoma and Bladder Carcinoma In Situ Detected During Evaluation of Incidental PSA Elevation: A Case Report Illustrating Multimodal Diagnostic Correlation and Long-Term Follow-Up"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-2691","authenticated-orcid":false,"given":"Simona Maria","family":"Borta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei Nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4374-4248","authenticated-orcid":false,"given":"Adrian Silviu","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Department of Intensive Care and Emergency Medicine, Faculty of Medicine,\u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolutiei Nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9542-0035","authenticated-orcid":false,"given":"Imola","family":"Miklos","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Science, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei Nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Zdremtan","sequence":"additional","affiliation":[{"name":"Department of Otorynolaryngology, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolutiei Nr. 94-96, 310025 Arad, Romania"},{"name":"Department of Biochemistry, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolutiei Nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-388X","authenticated-orcid":false,"given":"Roxana Andra","family":"Coman","sequence":"additional","affiliation":[{"name":"Department of Urology, MedLife Humanitas Hospital, 400664 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.eururo.2018.09.034","article-title":"External Beam Radiotherapy Increases the Risk of Bladder Cancer When Compared with Radical Prostatectomy in Patients Affected by Prostate Cancer: A Population-based Analysis","volume":"75","author":"Moschini","year":"2019","journal-title":"Eur. 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