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Viehweger F, Böcker C, Weidemann S, Freytag M, Menz A, Büscheck F, Luebke AM, Putri D, Kluth M, Hube-Magg C, Hinsch A, Lennartz M, Lutz F, Reiswich V, Höflmayer D, Fraune C, Möller K, Bernreuther C, Lebok P, Sauter G, Steurer S, Dum D, Marx AH, Simon R, Krech T, Clauditz TS, Jacobsen F, Gorbokon N, Burandt E, Minner S, Kind S. Prostein expression in human tumors: a tissue microarray study on 19,202 tumors from 152 different Tumor entities. Diagn Pathol 2024; 19:12. [PMID: 38218896 PMCID: PMC10788021 DOI: 10.1186/s13000-023-01434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/21/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Prostein (P501S), also termed solute carrier family 45 member 3 (SLC45A3) is an androgen regulated protein which is preferentially expressed in prostate epithelial cells. Because of its frequent expression in prostate cancer, prostein was suggested a diagnostic prostate cancer marker. METHODS In order to comprehensively assess the diagnostic utility of prostein immunohistochemistry, a tissue microarray containing 19,202 samples from 152 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. RESULTS Prostein immunostaining was typically cytoplasmic, granular and perinuclear. Prostein positivity was seen in 96.7% of 419 prostate cancers including 78.3% with strong staining. In 16,709 extra-prostatic tumors, prostein positivity was observed in 7.2% of all cases but only 0.3% had a strong staining. Overall, 50 different extra-prostatic tumor categories were prostein positive, 12 of which included at least one strongly positive case. Extra-prostatic tumors with highest rates of prostein positivity included different subtypes of salivary gland tumors (7.6-44.4%), neuroendocrine neoplasms (15.8-44.4%), adenocarcinomas of the gastrointestinal tract (7.3-14.8%), biliopancreatic adenocarcinomas (3.6-38.7%), hepatocellular carcinomas (8.1%), and adenocarcinomas of other organs (up to 21%). CONCLUSIONS Our data provide a comprehensive overview on prostein expression in human cancers. Prostein is a highly sensitive prostate cancer marker occurring in > 96% of prostate cancers. Because prostein can also be expressed in various other tumor entities, classifying of a tumor mass as a prostate cancer should not be based on prostein positivity alone.
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Affiliation(s)
- Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Carola Böcker
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Morton Freytag
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Devita Putri
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Florian Lutz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Viktor Reiswich
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Am Finkenhuegel 1, Osnabrueck, 49076, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas H Marx
- Department of Pathology, Academic Hospital Fuerth, Jakob-Henle-Straße 1, Fuerth, 90766, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Am Finkenhuegel 1, Osnabrueck, 49076, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Simon Kind
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Prashanth KA, Jain D, Manikandan R, Kalyan S, Velayutham V, Surendran R. Signet cell rectal carcinoma with prostatic involvement detected by FAPI-04 PET-MRI fusion. Eur J Hybrid Imaging 2023; 7:26. [PMID: 38036687 PMCID: PMC10689635 DOI: 10.1186/s41824-023-00183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 12/02/2023] Open
Abstract
A 60-year-old male patient diagnosed with mucinous adenocarcinoma of lower third of rectum underwent abdominoperineal resection and permanent colostomy followed by adjuvant chemotherapy. Response evaluation with F-18 FDG PET-CT showed a complete metabolic response. After 6 months, CEA levels started increasing and clinically a recurrence was suspected. A restaging FDG PET-CT showed no obvious malignant disease. Patient presented again within a month with complaints of urinary retention and haematuria. CEA levels were further elevated, and Ga-68 FAPI-04 (FAPI) PET-CT was performed. FAPI PET-CT revealed prostatic and seminal vesicle disease involvement. Additionally, an MRI of pelvis was done and fused with FAPI PET for confirmation of prostatic involvement.
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Affiliation(s)
- K Arun Prashanth
- Department of Nuclear Medicine, MIOT International Hospital, Chennai, India.
| | - Deepti Jain
- Department of Lab Services, MIOT International Hospital, Chennai, India
| | - R Manikandan
- Department of Urology, MIOT International Hospital, Chennai, India
| | - Suman Kalyan
- Department of Medical Oncology, MIOT International Hospital, Chennai, India
| | - Vimalraj Velayutham
- Department of Hepato-Pancreato-Biliary Centre for Surgery and Transplantation, MIOT International Hospital, Chennai, India
| | - R Surendran
- Department of Hepato-Pancreato-Biliary Centre for Surgery and Transplantation, MIOT International Hospital, Chennai, India
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3
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Wang P, Joiner M, Dzul S, Miller SR. Adenocarcinoma involving the urinary bladder. BMJ Case Rep 2023; 16:e252747. [PMID: 37463778 DOI: 10.1136/bcr-2022-252747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
A man in his 70s previously diagnosed with an adenocarcinoma of the prostate, received external beam radiation therapy (EBRT) and brachytherapy 11 years ago. Ten years later, he developed urinary symptoms and a cystoscopy identified a bladder neck tumour. A transurethral resection of a bladder tumour was performed, and pathology revealed a high-grade adenocarcinoma consistent with a colorectal primary. A colonoscopy was unremarkable, and imaging studies showed tumour involving the bladder and prostate. Tumour markers and a CARIS genomic prevalence score also favoured a colorectal cancer primary.The patient refused surgery and underwent chemoradiation with a combination of EBRT and brachytherapy with concurrent capecitabine. Imaging studies obtained 6 months after reirradiation revealed an enlarged left-sided mesorectal lymph node concerning for disease recurrence. The lymph node was treated with Stereotactic Body Radiation Therapy and his post-treatment imaging revealed a response to treatment with no other evidence of disease.
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Affiliation(s)
- Pule Wang
- School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Michael Joiner
- Oncology, Wayne State University, Detroit, Michigan, USA
| | - Stephen Dzul
- School of Medicine, Wayne State University, Detroit, Michigan, USA
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Zhu W, Wu J, Wu L, Meng J, Fang C, Zhang H. Ascending colon cecal junction carcinoma with prostate metastasis: A case report and literature review. Medicine (Baltimore) 2023; 102:e33308. [PMID: 36930066 PMCID: PMC10019226 DOI: 10.1097/md.0000000000033308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
RATIONALE Colon carcinoma is the most common type of cancer, and a leading cause of cancer-related death. Clinically, the most common sites of metastases from colon carcinoma are the liver, lungs, peritoneum, and lymph nodes, while the incidence of metastases to the prostate is low. There are few relevant studies on colon carcinoma, most of them being case reports. PATIENT CONCERNS A 76-year-old man treated with radical resection of right colon carcinoma due to primary poorly differentiated adenocarcinoma of the cecum. Postoperative pathological examination suggested that he had cancer at the junction of the ascending colon and the cecum. He had received adjuvant chemotherapy after surgery. One year later, he received transurethral plasma resection of the prostate due to urinary system discomfort. Postoperative pathological immunohistochemistry suggested prostate metastasis of colorectal carcinoma, and he received individualized treatment, but this produced no clear survival benefit. DIAGNOSES Ascending colon cecal junction carcinoma with prostate metastasis. INTERVENTIONS Radical resection, chemotherapy, anti-androgen therapy, surgery to relieve primary lesion obstruction symptoms, and local radiotherapy of the prostate. OUTCOMES At present, clinical cases of colon carcinoma with prostate metastasis are rare. By sharing a rare case of ascending colon cecal junction carcinoma with prostate metastasis and reviewing the relevant literature, this paper explores and optimizes the clinical treatment of colon carcinoma with prostate metastasis.
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Affiliation(s)
- Wanshan Zhu
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
| | - Jiaming Wu
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
| | - Lexia Wu
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
| | - Jincheng Meng
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
| | - Cantu Fang
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
| | - Huatang Zhang
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
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5
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Clinicopathologic Spectrum of Secondary Solid Tumors of the Prostate of Nonurothelial Origin. Am J Surg Pathol 2022; 46:1269-1276. [DOI: 10.1097/pas.0000000000001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Dema S, Bota A, Tăban SM, Gheju A, Dema ALC, Croitor A, Barna RA, Popa O, Bardan R, Cumpănaș AA. Multiple Primary Tumors Originating From the Prostate and Colorectum A Clinical-Pathological and Therapeutic Challenge. Am J Mens Health 2021; 15:15579883211044881. [PMID: 34493123 PMCID: PMC8436322 DOI: 10.1177/15579883211044881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Considering that the incidence of colorectal (CRC) and prostatic cancer (PC) increases with age, metachronous and synchronous tumors can often affect the same patient. Despite the importance of this subject for the diagnosis and management of oncologic patients, in medical literature the data are scarce. The aim of the study was to evaluate the incidence and the characteristics of double/multiple primary malignant tumors (D/MPMTs) with colorectal and prostatic origin, in patients admitted to a reference hospital in West Romania. A 4-year retrospective observational study (2016–2019) was conducted by analyzing the medical records of all patients admitted in the hospital. Demographic and clinical data, as well as tumor-related parameters, were extracted. We identified 413 consecutive hospitalized patients with PC, and 21 (5%) of them also had a primary CRC. At the time of diagnosis, the mean age of the patients with PC was 71.2 ± 6 years, and 71.8 ± 10 years for patients with CRC. Synchronous PC and CRC tumors were identified in 3/21 cases and metachronous tumors in 18/21 cases. Prostate cancer was the first tumor to be diagnosed in 13/18 cases and CRC in 5/18 cases. The most frequent subtype of PC was acinar adenocarcinoma (90%) and for CRC cases, conventional adenocarcinoma (90%). Prostate and colorectal cancers tend to co-occur in a single patient. The diagnosis of one of these two types of tumors should imply the screening for the other one, because these patients require a multidisciplinary and personalized approach.
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Affiliation(s)
- Sorin Dema
- Radiotherapy Service, Emergency City Hospital Timisoara, Timisoara, Romania
| | - Andreea Bota
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorina Maria Tăban
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Adelina Gheju
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alis Liliana Carmen Dema
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alexei Croitor
- Urology Department, Emergency County Hospital Timisoara, Timisoara, Romania
| | - Robert Alexandru Barna
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,Department of Internal Medicine II-Discipline of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Oana Popa
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Răzvan Bardan
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alin-Adrian Cumpănaș
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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Nepal P, Nagar A, Tirumani SH, Ojili V. Imaging of non-epithelial neoplasms of the prostate. Abdom Radiol (NY) 2020; 45:4117-4132. [PMID: 32964275 DOI: 10.1007/s00261-020-02774-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 02/05/2023]
Abstract
The purpose of this article is to review the spectrum of rare non-epithelial tumors of the prostate. This focused article will help the readers to understand the imaging findings of such rare entities attributed to their clinicopathological features. Radiologists must be familiar with the spectrum of non-epithelial tumors of the prostate, which helps to suggest alternate diagnosis other than adenocarcinoma, when imaging features are atypical. This is important because these tumors have different management approaches and prognoses when compared to adenocarcinoma of the prostate.
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Affiliation(s)
- Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sree Harsha Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
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8
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Park JJ, Snow ZA, Lurz KL, Edwards DC, Belkoff LH, Cahn DB. A Rare Case of Signet Ring Cell Carcinoma of the Colon With Selective Metastasis to the Prostate. Urology 2020; 143:e17-e19. [PMID: 32504679 DOI: 10.1016/j.urology.2020.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/26/2020] [Accepted: 05/17/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jasmine J Park
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA.
| | | | - Kelly L Lurz
- Department of Urology, Main Line Health, Bryn Mawr, PA
| | | | | | - David B Cahn
- Department of Urology, Main Line Health, Bryn Mawr, PA
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Gys B, Fransis K, Hubens G, Van den Broeck S, Op de Beeck B, Komen N. Simultaneous laparoscopic proctocolectomy (TaTME) and robot-assisted radical prostatectomy for synchronous rectal and prostate cancer. Acta Chir Belg 2019; 119:47-51. [PMID: 29198168 DOI: 10.1080/00015458.2017.1411550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE We would like to present a patient with a history of ulcerative colitis suffering from a synchronous rectal and prostate cancer treated with a laparoscopic total proctocolectomy (with TaTME) and Retzius sparing RARP simultaneously. METHODS Retzius sparing RARP with bilateral lymph node harvesting was performed first. Afterwards, TaTME was commenced with the placement of a Lonestar® retractor and GelPort®. Anterior dissection was troubled unexpectedly by outspoken fibrosis. For that reason, it was completed laparoscopically. We then continued with the laparoscopic total proctocolectomy. Last, a transanal circular stapled ileoanal anastomosis was created and a derivating ileostomy was installed. RESULTS Postoperative proctoscopy showed a patent ileoanal anastomosis. After removal of the Foley catheter on day 21, the patient was immediately continent. Prostate specimen revealed a pT2cN1M0 transmural invasive adenocarcinoma with a Gleason score of 7 (3 + 4). Pathology analysis of the rectum revealed a stage IIIc transmural invasive moderately differentiated rectal adenocarcinoma (pT3N2bM0) with free margins. He was referred for adjuvant chemotherapy. CONCLUSIONS In this case, the combination of TaTME and Retzius sparing RARP for synchronous rectal and prostate cancer was feasible and safe. We suggest performing the anterior TaTME dissection last, due to disturbing blood flow into the operating field after prostatectomy.
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Affiliation(s)
- Ben Gys
- Dienst Abdominale, Kinder-en Reconstructieve Heelkunde, UZA, Antwerpen, Belgium
| | | | - Guy Hubens
- Dienst Abdominale, Kinder-en Reconstructieve Heelkunde, UZA, Antwerpen, Belgium
| | | | | | - Niels Komen
- Dienst Abdominale, Kinder-en Reconstructieve Heelkunde, UZA, Antwerpen, Belgium
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10
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Iczkowski KA. Large-Gland Proliferations of the Prostate. Surg Pathol Clin 2018; 11:687-712. [PMID: 30447836 DOI: 10.1016/j.path.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Large-gland proliferations of the prostate have gained considerable attention in the past decade. The differential diagnosis is quite broad but can be refined using histologic criteria and, sometimes, immunostains. Pathologists have come to realize that cribriform and intraductal as well as ductal carcinomas are particularly aggressive patterns, and should name them in diagnostic reporting when present.
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Affiliation(s)
- Kenneth A Iczkowski
- Department of Pathology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
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11
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Mucinous and secondary tumors of the prostate. Mod Pathol 2018; 31:S80-S95. [PMID: 29297488 DOI: 10.1038/modpathol.2017.132] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 12/19/2022]
Abstract
Primary mucinous tumors and secondary tumors involving the prostate gland are relatively uncommon, however they have important diagnostic, therapeutic, and prognostic implications. The primary mucinous tumors of the prostate include mucinous (colloid) adenocarcinoma of the prostate, prostatic adenocarcinoma with mucinous features, and mucinous adenocarcinoma of the prostatic urethra (mucin-producing urothelial-type adenocarcinoma of the prostate). Mucinous adenocarcinoma of the prostate is defined as a primary prostatic acinar tumor characterized by the presence of at least 25% of the tumor composed of glands with extraluminal mucin. This diagnosis can only be made in radical prostatectomy specimens. Recent studies have shown that these tumors have a similar or in some cases better prognosis than conventional prostatic adenocarcinoma treated by radical prostatectomy. The preferred terminology for tumors that are composed of <25% extraluminal mucinous component in radical prostatectomy specimens is 'prostatic adenocarcinoma with mucinous features.' All cases of prostatic adenocarcinoma with extraluminal mucinous components in prostate needle core biopsies or transurethral resection of the prostate specimens are also referred to as 'prostatic adenocarcinoma with mucinous features.' Mucinous adenocarcinoma of the prostatic urethra (mucin-producing urothelial-type adenocarcinoma of the prostate) as the name implies, does not arise from prostatic acini or ducts, and is a distinct entity that arises from the prostatic urethra usually from urethritis glandularis or glandular metaplasia with malignant transformation, and is analogous to adenocarcinoma with mucinous differentiation arising from the urinary bladder. This tumor is aggressive and has a relatively poor prognosis. The most common secondary tumors that arise from adjacent organs and spread (direct extension or metastasis) to the prostate gland, include urothelial carcinoma of the bladder and colorectal adenocarcinoma. Other secondary tumors that may involve the prostate include metastatic epithelial tumors from several other sites, malignant melanoma and soft tissue tumors.
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12
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Park M, Kim SC, Chung JS, Park SH, Park SS, Oh SJ, Lee D, Rha KH, Oh CK. Simultaneous robotic low anterior resection and prostatectomy for adenocarcinoma of rectum and prostate: initial case report. SPRINGERPLUS 2016; 5:1768. [PMID: 27795910 PMCID: PMC5059363 DOI: 10.1186/s40064-016-3456-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 10/04/2016] [Indexed: 11/25/2022]
Abstract
Background We report a case of synchronous rectal and prostate cancer treated successfully with simultaneous da Vinci robotic-assisted low anterior resection of the rectum and robotic-assisted laparoscopic radical prostatectomy to address both cancers. Case presentation Recently, minimally invasive surgical techniques using da Vinci robot® system (Intuitive Surgical, Sunnyvale, USA) were introduced as curative surgical modality of prostate and rectal malignancies. Herein, we report an initial case of simultaneous robotic low anterior resection and robotic prostatectomy for adenocarcinoma of rectum and prostate sharing a considerable number of port sites. Conclusion Simultaneous robotic-assisted low anterior resection could be performed with robotic-assisted radical prostatectomy safely and effectively in synchronous rectal and prostate cancer.
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Affiliation(s)
- Myungchan Park
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
| | - Seong Cheol Kim
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
| | - Jae-Seung Chung
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
| | - Sang Hyun Park
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
| | - Seok San Park
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
| | - Sung Jin Oh
- Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Donghoon Lee
- Department of Convergence Medical Science, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Cheol Kyu Oh
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, 248, Jwadongsunhwan-ro, Haeundae-gu, Busan, Korea
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Abstract
Metastatic involvement of the prostate from noncontiguous solid tumors is a rare event occurring by means of vascular dissemination. The reported cases of biopsy and surgical samples with metastatic involvement have increased; however, a comprehensive understanding of secondary tumors of the prostate is currently missing. Metastases to the prostate carry a dismal prognosis and may pose serious diagnostic challenges to both clinicians and pathologists, with crucial therapeutic implications. Secondary tumors of the prostate spread more frequently from the digestive tract, the lung, and the kidney. The integration of clinicoradiologic data with appropriate pathologic and immunohistochemical analyses is essential for the identification and the characterization of secondary tumors of the prostate, whereas molecular analyses could provide additional and complementary information, enabling precise diagnosis and appropriate clinical management. Patients with solitary metastases could benefit from prostatic resection and adjuvant therapy, whereas in cases of disseminated diseases, symptom control may be obtained with palliative procedures. The purpose of this review was to assess the current state of knowledge of secondary tumors involving the prostate gland and to discuss short-term future perspectives, while providing a practical approach to these uncommon conditions for pathologists and oncologists.
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14
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Primary enteric-type mucinous adenocarcinoma of the urethra in a patient with ulcerative colitis. Int Surg 2016; 99:669-72. [PMID: 25216440 DOI: 10.9738/intsurg-d-13-00073.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary carcinoma of the male urethra accounts for less than 1% of malignancies in men. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is poorly understood. We present herein a rare case of mucinous urethral adenocarcinoma in a male patient with longstanding ulcerative colitis and multiple sclerosis. The patient presented with a voluminous pelvic mass; core biopsy of the lesion demonstrated a mucus-producing adenocarcinoma. Given the patient's history of subtotal colectomy, preoperative diagnosis was oriented towards a rectal stump adenocarcinoma. The patient underwent a pelvic exenteration: surprisingly, histology marked the prostatic urethra as the primary lesion site.
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Adeniran AJ, Humphrey PA. Morphologic Updates in Prostate Pathology. Surg Pathol Clin 2015; 8:539-60. [PMID: 26612214 DOI: 10.1016/j.path.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the past several years, modifications have been made to the original Gleason system with resultant therapeutic and prognostic implications. Several morphologic variants of prostatic adenocarcinoma have also been described. Prostate pathology has also evolved over the years with the discovery and utility of new immunohistochemical stains. The topics discussed in this update include the Gleason grading system, prognostic grade grouping, variants of prostatic adenocarcinoma, and the application of immunohistochemistry to prostate pathology.
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Affiliation(s)
- Adebowale J Adeniran
- Department of Pathology, Yale University School of Medicine, 310 Cedar Street, LH 108, New Haven, CT 06520, USA.
| | - Peter A Humphrey
- Department of Pathology, Yale University School of Medicine, 310 Cedar Street, LH 108, New Haven, CT 06520, USA
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Best Practices Recommendations in the Application of Immunohistochemistry in the Prostate. Am J Surg Pathol 2014; 38:e6-e19. [DOI: 10.1097/pas.0000000000000238] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Semino-Mora C, Testerman TL, Liu H, Whitmire JM, Studeman K, Jia Y, McAvoy TJ, Francis J, Nieroda C, Sardi A, Merrell DS, Dubois A. Antibiotic treatment decreases microbial burden associated with pseudomyxoma peritonei and affects β-catenin distribution. Clin Cancer Res 2013; 19:3966-76. [PMID: 23743566 DOI: 10.1158/1078-0432.ccr-13-0616] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Pseudomyxoma peritonei is an understudied cancer in which an appendiceal neoplasm invades the peritoneum and forms tumor foci on abdominal organs. Previous studies have shown that bacteria reside within pseudomyxoma peritonei tumors and mucin. Thus, we sought to analyze the effect of antibiotics on bacterial density and β-catenin expression within pseudomyxoma peritonei samples. EXPERIMENTAL DESIGN The study included 48 patients: 19 with disseminated peritoneal adenomucinosis (DPAM) and 29 with peritoneal mucinous carcinomatosis (PMCA). Fourteen patients were given antibiotics (30 mg lansoprazole, 1 g amoxicillin, and 500 mg clarithromycin) twice a day for 14 days. One week after completion of therapy, surgery was conducted and specimens were harvested for pathology, bacterial culture, ISH, and immunohistochemistry. RESULTS ISH showed the presence of bacteria in 83% of the patient samples, with a higher Helicobacter pylori density observed in PMCA versus DPAM. PMCA patients treated with antibiotics had a significantly lower bacterial density and decreased β-catenin levels in the cytoplasm, the cell nuclei, and mucin-associated cells. Although not significant, similar trends were observed in DPAM patients. Cell membrane β-catenin was significantly increased in both DPAM and PMCA patients receiving antibiotics. CONCLUSIONS Bacteria play an important role in pseudomyxoma peritonei. Antibiotic treatment improved the histopathology of tissue, particularly in PMCA patients. In PMCA, antibiotics decreased bacterial density and were associated with a significant β-catenin decrease in the cytoplasm, cell nuclei, and mucin along with a small membrane increase. These results suggest that antibiotics offer potential protection against cell detachment, cellular invasion, and metastasis.
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Affiliation(s)
- Cristina Semino-Mora
- Uniformed Services University and United States Military Cancer Institute, Bethesda, Maryland 20814, USA
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Gopalan V, Smith RA, Ho YH, Lam AKY. Signet-ring cell carcinoma of colorectum--current perspectives and molecular biology. Int J Colorectal Dis 2011; 26:127-33. [PMID: 20686774 DOI: 10.1007/s00384-010-1037-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2010] [Indexed: 02/08/2023]
Abstract
PURPOSE Colorectal signet-ring cell carcinoma (SRCC) is rare, and very little detailed information on the molecular biology of the disease is available. METHODS The literature on the clinical, pathological and, in particular, the molecular biology of this rare entity was critically reviewed. The reviewed articles take into account a total of 1,817 cases of SRCC, but only 143 cases have molecular data available. The characteristics of two patients with colorectal SRCC were also discussed. RESULTS Colorectal SRCC mostly occurs in younger patients, is larger and has different site predilection compared with conventional colorectal adenocarcinoma. It can occur as one of the synchronous cancers in the colorectum. The cancer is usually diagnosed at advanced stages because of the late manifestation of symptoms, and aggressive treatment strategy is required. Limited reports in the literature have shown that the variant of colorectal cancer demonstrated a different pattern of genetic alterations of common growth kinase-related oncogenes (K-ras, BRAF), tumour suppressor genes (p53, p16), gene methylation and cell adhesion-related genes related to the Wingless signalling pathway (E-cadherin and beta-catenin) from conventional colorectal adenocarcinoma. Colorectal SRCC also showed high expression of mucin-related genes and genes related to the gastrointestinal system. There was also a higher prevalence of microsatellite instability-high tumours and low Cox-2 expression in colorectal SRCC as opposed to conventional adenocarcinoma. CONCLUSIONS Colorectal SRCC has unique molecular pathological features. The unique molecular profiles in SRCC may provide molecular-based improvements to patient management in colorectal SRCC.
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Affiliation(s)
- Vinod Gopalan
- School of Medicine, Griffith Health Institute, Gold Coast, QLD, Australia
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Lee TK, Miller JS, Epstein JI. Rare histological patterns of prostatic ductal adenocarcinoma. Pathology 2010; 42:319-24. [DOI: 10.3109/00313021003767314] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Guo CC, Pisters LL, Troncoso P. Prostate cancer invading the rectum: a clinicopathological study of 18 cases. Pathology 2010; 41:539-43. [PMID: 19900102 DOI: 10.1080/00313020903071611] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS Prostate cancer may involve the rectum and cause severe perineal pain. The aim of this study was to understand the rectal involvement by prostate cancer and its clinical significance. METHODS We evaluated pathological and clinical features of 18 cases of prostate cancer with rectal involvement. RESULTS All patients presented with intractable perineal pain. Twelve patients received rectal biopsies, which revealed poorly differentiated prostatic adenocarcinoma (n = 6), squamous cell carcinoma (n = 3), angiosarcoma (n = 1), or no tumour (n = 2). All patients received palliative total pelvic exenteration, which demonstrated prostate cancer invading the rectal wall. In these resection specimens, the tumour consisted of poorly differentiated prostatic adenocarcinoma (n = 16), squamous cell carcinoma (n = 1), or angiosarcoma (n = 1). In addition, six cases of prostatic adenocarcinomas also showed focal squamous (n = 3) or high-grade neuroendocrine (n = 3) differentiation. Nine patients died at a mean time of 18 months (range, 2-69 months) after surgery. The remaining nine patients were alive with a mean follow-up time of 15 months (range, 3-34 months), but four patients developed distant metastases. CONCLUSIONS Prostate cancer with rectal involvement often develops heterogeneous differentiation and carries a dismal prognosis.
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Affiliation(s)
- Charles C Guo
- Department of Pathology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030-4009, USA.
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Morichetti D, Mazzucchelli R, Lopez-Beltran A, Cheng L, Scarpelli M, Kirkali Z, Montorsi F, Montironi R. Secondary neoplasms of the urinary system and male genital organs. BJU Int 2009; 104:770-6. [PMID: 19624595 DOI: 10.1111/j.1464-410x.2009.08746.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS In this review we discuss those secondary tumours involving the urinary system and male genital organs that can pose differential diagnostic difficulties with primary lesions, and highlight morphological and ancillary features that could be helpful in reaching a proper assignment of primary origin. MATERIALS AND METHODS Based on MEDLINE database searches all reports of secondary tumours involving the urinary system (kidney and bladder) and male genital organs (prostate, testis and penis) were examined. RESULTS AND DISCUSSION Involvement by a secondary tumour occurs either as a metastasis or by direct extension. Among non-genitourinary primary sites, colorectal, pulmonary, skin (melanoma) and breast are the most common contributors. Secondary spread from a genitourinary site primary tumour to another genitourinary organ occurs most frequently between the prostate and urinary bladder, given the intimate topographic proximity of the two. The prognosis is very poor, as the secondary tumour usually occurs in patients with carcinoma in the late stages. Few secondary tumours have distinctive histological and immunohistochemical features, making it difficult to make the appropriate diagnosis. Hence, knowledge of the history and clinical setting are particularly important in these cases. CONCLUSION The urinary system and male genital organs are not common sites for secondary tumours. They often go either undiagnosed or misdiagnosed in the clinical follow-up of patients with cancer. Accurate diagnosis is essential because of differing therapeutic approaches compared with a primary neoplasm.
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Affiliation(s)
- Doriana Morichetti
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
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Paner GP, Luthringer DJ, Amin MB. Best practice in diagnostic immunohistochemistry: prostate carcinoma and its mimics in needle core biopsies. Arch Pathol Lab Med 2008; 132:1388-96. [PMID: 18788849 DOI: 10.5858/2008-132-1388-bpidip] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT The unrelenting challenge encountered when differentiating limited-volume prostate carcinoma and sometimes subtle variants from its many morphologic mimics has increased the use of ancillary immunohistochemistry in routine prostate needle biopsies. The availability of prostate cancer-associated and basal cell-associated markers has been an invaluable addition to diagnostic surgical pathology. OBJECTIVE To review commonly used immunohistochemical stains, including innovative combinations, for confirmation or differential diagnosis of prostate carcinoma, and to propose appropriately constructed panels using morphologic patterns in prostate needle biopsies. DATA SOURCES These best practices are based on our experience with routine and consultative case sign-outs and on a review of the published English-language literature from 1987 through 2008. CONCLUSIONS Basal cell-associated markers p63, high-molecular-weight cytokeratin 34 beta E12, cytokeratin 5/6 or a cocktail containing p63 and high-molecular-weight cytokeratin 34 beta E12 or cytokeratin 5/6 and prostate carcinoma-specific marker alpha-methylacyl coenzyme A (coA) racemase alone or in combination are useful adjuncts in confirming prostatic carcinoma that either lacks diagnostic, qualitative or quantitative features or that has an unusual morphologic pattern (eg, atrophic, pseudohyperplastic) or is in the setting of prior treatment. The combination of alpha-methylacyl coA racemase positivity with negative staining for basal cell-associated markers supports a malignant diagnosis in the appropriate morphologic context. Dual chromogen basal cell- associated markers (p63 [nuclear] and high-molecular-weight cytokeratin 34 beta E12/cytokeratin 5/6 [cytoplasmic]) and alpha-methylacyl coA racemase in an antibody cocktail provide greater sensitivity for the basal cell layer, easing evaluation and minimizing loss of representation of the focal area interest because the staining is performed on one slide. In the posttreatment setting, pancytokeratin facilitates detection of subtle-treated cancer cells. Prostate-specific antigen and prostatic acid phosphatase markers are helpful in excluding secondary malignancies involving the prostate, such as urothelial carcinoma, and occasionally in excluding nonprostatic benign mimickers, such as nephrogenic adenoma, mesonephric gland hyperplasia, and Cowper glands. There is no role for ordering immunohistochemistry prospectively in all cases of prostatic needle biopsies.
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Affiliation(s)
- Gladell P Paner
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Prostatic adenocarcinoma in colorectal biopsy: clinical and pathologic features. Hum Pathol 2008; 39:543-9. [DOI: 10.1016/j.humpath.2007.08.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 08/14/2007] [Accepted: 08/16/2007] [Indexed: 11/22/2022]
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Yamaguchi S, Hashimoto H, Kaneko S, Tokunaka S, Yachiku S. Secondary mucinous adenocarcinoma of the prostate in a patient with ulcerative colitis. Urol Int 1993; 50:231-3. [PMID: 8389496 DOI: 10.1159/000282492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Herein we report a rare case of prostatic invasion of rectal carcinoma in a patient with ulcerative colitis. Malignant transformation is a well-known complication of long-standing ulcerative colitis. Mucinous adenocarcinoma, with positive carcinoembryonic antigen and negative prostate-specific antigen, strongly suggested the rectal origin of the tumor.
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Affiliation(s)
- S Yamaguchi
- Department of Urology, Asahikawa Medical College, Japan
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