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

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.