Al-Hussain T, et al. - Researchers sought to report the first case of a plasmacytoid variant of prostatic adenocarcinoma. The case was of a 54-year-old male who presented with recurrent attacks of acute urinary retention. High creatinine and a serum prostate-specific antigen of 50.7 μg/L were detected in laboratory findings. In MRI, they identified a locally advanced tumor that involved the bladder and extended to the base of the prostate with bilateral ureterovesical junction involvement and invasion of the left seminal vesicle and left anterior mesorectal fascia as well as perirectal fat invasion. They recognized diffuse metastases to the abdominopelvic lymph nodes. Multiple bone metastases were noted in bone scintigraphy. Transurethral resection of the bladder tumor was done in this patient. Sheets of malignant cells with prominent plasmacytoid appearance undermining benign urothelium were identified in microscopic examination. The tumor cells were noted as positive for PSA, PSAP, NKX 3.1 and Cytokeratin 8/18 and were noted as negative for P63, Cytokeratin 34βE12, Cytokeratin 20, Desmin, CD38, Kappa and Lambda light chains, Chromogranin, Synaptophysin, GATA 3, E-cadherin and CD45. INI1 was retained. An intermediate tumor mutational burden was identified in next generation sequencing. Notably, there were no genomic alterations in the CDH1 gene (encoding for E-cadherin). Some initial response to antiandrogen therapy was observed in the patient with a drop in serum PSA levels following androgen deprivation therapy. However, 6 months after diagnosis, the patient died. They suggest recognition of this newly described variant and its differentiation from plasmacytoid urothelial carcinoma as critical. Identification of the newly described plasmacytoid variant of adenocarcinoma of the prostate will result in classifying and recording more cases and a better knowledge concerning its clinicopathologic features.