Malakoplakia is an unusual chronic granulomatous inflammatory disorder that was originally described as affecting the bladder, but which has subsequently been found in other organs. Clinically the symptoms and physical findings are similar to those of low urinary tract syndrome, and in half of patients, the differential diagnosis includes malignancy, mainly because of the presence of a hard nodule on digital rectal examination and because the ultrasonographic findings mimic prostatic adencarcionma. We report a rare case of prostatic malakoplkia in conjunction with a prostatic adenocarcinoma.