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Lesko P, Obertova J, Kajo K, Rejlekova K, Orszaghova Z, Lehotska V, Ondrusova M, Chovanec M, Ondrus D, Mego M. Testicular Seminoma in Prostate: Case Report and Review of Literature. Clin Genitourin Cancer 2024; 22:210-216. [PMID: 38040557 DOI: 10.1016/j.clgc.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Peter Lesko
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Jana Obertova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Karol Kajo
- Department of Pathology, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Katarina Rejlekova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Zuzana Orszaghova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Viera Lehotska
- 2nd Department of Radiology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Martina Ondrusova
- Department of Preventive and Clinical Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Michal Chovanec
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1st Department of Oncology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Michal Mego
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic.
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Cao ZL, Lian BJ, Chen WY, Fang XD, Jin HY, Zhang K, Qi XP. Diagnosis and treatment of primary seminoma of the prostate: A case report and review of literature. World J Clin Cases 2023; 11:2267-2275. [PMID: 37122514 PMCID: PMC10131029 DOI: 10.12998/wjcc.v11.i10.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Primary seminoma of the prostate (PSP) is a rare type of extragonadal germ cell tumour that is easily misdiagnosed, owing to the lack of specific clinical features. It is therefore necessary for clinicians to work toward improving the accuracy of PSP diagnosis.
CASE SUMMARY A 59-year-old male patient presenting with acute urinary retention was admitted to a local hospital. A misdiagnosis of benign prostatic hyperplasia led to an improper prostatectomy. Histopathology revealed PSP invading the bladder neck and bilateral seminal vesicles. Further radiotherapy treatment for the local lesion was performed, and the patient had a disease-free survival period of 96 mo. This case was analysed along with 13 other cases of PSP identified from the literature. Only four of the cases (28.6%) were initially confirmed by prostate biopsy. In these cases, imaging examinations showed an enlarged prostate (range 6-11 cm) involving the bladder neck (13/14). Of the 14 total cases, 11 (78.6%) presented typical pure seminoma cell features, staining strongly positive for placental alkaline phosphatase, CD117, and OCT4. The median age at diagnosis was 51 (range 27-59) years, and patients had a median progression-free survival time of 48 (range 6-156) mo after treatment by cisplatin-based chemotherapy combined with surgery or radiotherapy. The remaining three were cases of mixed embryonal tumours with focal seminoma, which had clinical features similar to those of pure PSP, in addition that they also had elevated serum alpha-fetoprotein, beta-human chorionic gonadotropin, and lactose dehydrogenase.
CONCLUSION PSP should be considered in patients younger than 60 years with an enlarged prostate invading the bladder neck. Further prostate biopsies may aid in proper PSP diagnosis. Cisplatin-based chemotherapy is still the main primary therapy for PSP.
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Affiliation(s)
- Zhi-Lie Cao
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Bi-Jun Lian
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Wei-Ying Chen
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 318050, Zhejiang Province, China
| | - Xu-Dong Fang
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Hang-Yang Jin
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Ke Zhang
- Center for Radiation Oncology, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou 310002, Zhejiang Province, China
| | - Xiao-Ping Qi
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
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Shi D, Chen C, Huang H, Tian J, Zhou J, Jin S. Primary seminoma of prostate in a patient with Klinefelter syndrome: A case report. Medicine (Baltimore) 2022; 101:e29117. [PMID: 35512069 PMCID: PMC9276372 DOI: 10.1097/md.0000000000029117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/03/2022] [Indexed: 01/14/2023] Open
Abstract
RATIONALE Klinefelter syndrome (KS) is a sex differentiation syndrome that occurs in men and is characterized by the 47XXY genotype. An association between KS and cancer has also been reported. The occurrence of seminoma of the prostate in KS has not been reported in the literature to date. Primary seminoma should be included in the differential diagnosis of prostate neoplasms in patients with KS. PATIENT CONCERNS A 39-year-old man presenting with urinary retention was admitted to our hospital. Physical examination revealed sparse pubic hairs, atrophic testes, and an underdeveloped penis. Hormonal examination revealed significantly lowered serum testosterone levels and markedly higher follicle-stimulating hormone levels. A chromosomal examination was performed. Computed tomography and magnetic resonance imaging imaging showed a neoplasm in the left lobe of the prostate, and immunohistochemical examination of a transrectal needle biopsy of the prostate was performed. DIAGNOSES Chromosomal examination was exhibited a 47 XXY genotype. Histopathology and of Immunohistochemistry of the transrectal needle biopsy specimen confirmed a seminoma. No other neoplasm was found on systemic examination; therefore, the patient was diagnosed with primary prostate seminoma and Klinefelter syndrome. INTERVENTIONS The patient refused any treatment except catheterization because of religious reason. OUTCOMES The patient died 2 years later. LESSONS Primary seminoma should be included in the differential diagnosis of neoplasms of the prostate in patients with KS. Transrectal ultrasound-guided prostate needle biopsy is essential for the diagnosis of prostate neoplasms, and cisplatin-based chemotherapy remains the primary treatment for seminoma.
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Affiliation(s)
- Duncheng Shi
- Department of Urology, Xifeng People's Hospital, Huayuan East Road, Xifeng County, Guizhou Province, PR China
| | - Changjian Chen
- Department of Urology, Xifeng People's Hospital, Huayuan East Road, Xifeng County, Guizhou Province, PR China
| | - Huagang Huang
- Department of Urology, Shougang Shuigang General Hospital, Chayelin Road, Zhongshan District, Liupanshui City, Guizhou Province, PR China
| | - Jingyu Tian
- Department of Urology, Shougang Shuigang General Hospital, Chayelin Road, Zhongshan District, Liupanshui City, Guizhou Province, PR China
| | - Jianfang Zhou
- Department of Urology, Shougang Shuigang General Hospital, Chayelin Road, Zhongshan District, Liupanshui City, Guizhou Province, PR China
| | - Shihua Jin
- Department of Urology, Capital Medical University Affiliated Beijing Shijitan Hospital, No. 10 Yangfangdian Road, Haidian District, Beijing, PR China
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Baweja A, Mar N, Rezazadeh Kalebasty A. Late recurrence of localized pure seminoma in prostate gland: A case report. World J Clin Oncol 2022; 13:62-70. [PMID: 35116233 PMCID: PMC8790299 DOI: 10.5306/wjco.v13.i1.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/22/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Late relapses of early-stage germ cell tumors are rare. Most patients (-85%) with stage I seminoma are cured by radical orchiectomy. The detection of late relapse is challenging given the relative rarity of this phenomenon, and the fact that patients who have completed surveillance are usually not undergoing regular oncologic workup nor imaging. While many treatment options do exist for a patient with late relapse of seminoma, surgery is typically the mainstay as these tumors are generally thought to be more chemo-resistant.
CASE SUMMARY In this article, we describe the management of a patient with an early-stage pure seminoma who was subsequently identified to have a recurrence two decades later. We provide a review of the literature not only focused on clinical factors and biology, but also the management of late recurrences specifically in pure seminoma and in prostate gland.
CONCLUSION There is a paucity of data and treatment recommendations for this clinical entity, and a multidisciplinary approach emphasizing subspecialty expert consultation and patient education is imperative.
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Affiliation(s)
- Abinav Baweja
- Hematology/Oncology, UCI Medical Center, University of California, Orange, CA 92868, United States
| | - Nataliya Mar
- Hematology/Oncology, UCI Medical Center, University of California, Orange, CA 92868, United States
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Akingbade A, Gopaul D, Brastianos HC, Hubay S. Radiotherapy as a Single Modality in Primary Seminoma of the Prostate. Cureus 2021; 13:e14264. [PMID: 33959446 PMCID: PMC8093112 DOI: 10.7759/cureus.14264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Extragonadal germ cell tumors (EGCTs) are uncommon, and those involving the prostate are rare. We report on a primary seminoma of the prostate in a 56-year-old male presenting with scrotal pain, urinary frequency and urgency, and erectile dysfunction. Digital rectal examination revealed a hard, markedly enlarged prostate projecting posteriorly into the rectum. All 12 cores from ultrasound-guided prostate biopsy revealed malignant cells that stained positive for OCT4, PLAP, and CD117. Imaging revealed a 10.2 cm x 7.8 cm x 8.4 cm prostate mass with irregular nodular margins extending superiorly to the base of the bladder and posteriorly abutting the anterior rectal wall. There was no evidence of distant metastatic disease on both nuclear medicine and CT scans of the chest, abdomen, and pelvis. An 11 mm right internal iliac lymph node and several tiny sub-centimeter external iliac nodes were noted bilaterally. The patient was treated with radiotherapy to the prostate and pelvic lymph nodes. The pelvic lymph nodes were treated with 20 Gy in eight fractions, followed by a boost to the prostate for a further 20 Gy in eight fractions. There was a significant response during treatment that allowed an adaptive boost for a further 10 Gy in four fractions to bring the total dose to the prostate to 50 Gy in 20 fractions. Treatment was well tolerated. Adjuvant chemotherapy was not recommended. He remains disease-free 24 months post-treatment. This case report indicates that like most seminomas, extragonadal seminomas are exquisitely sensitive to radiotherapy and may be considered for the primary treatment of non-metastatic disease. To our knowledge, this is the first reported case of the sole use of radiotherapy to treat a primary seminoma of the prostate.
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Affiliation(s)
| | - Darin Gopaul
- Radiation Oncology, Grand River Regional Cancer Centre, Kitchener, CAN
| | | | - Stacey Hubay
- Medical Oncology, Grand River Regional Cancer Centre, Kitchener, CAN
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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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Gundavda K, Bakshi G, Prakash G, Menon S, Pal M. The Curious Case of Primary Prostatic Seminoma. Urology 2020; 144:e6-e9. [PMID: 32758494 DOI: 10.1016/j.urology.2020.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Kaival Gundavda
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ganesh Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Atypical Presentation of Seminoma in the Prostate - Case Report. Urology 2019; 132:33-36. [PMID: 31136770 DOI: 10.1016/j.urology.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/28/2019] [Accepted: 05/16/2019] [Indexed: 12/13/2022]
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Antunes HP, Almeida R, Sousa V, Figueiredo A. Mixed extragonadal germ cell tumour of the prostate. BMJ Case Rep 2018; 2018:bcr-2017-223603. [PMID: 29991542 DOI: 10.1136/bcr-2017-223603] [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: 11/04/2022] Open
Abstract
Extragonadal germ cell tumours (EGGCTs) originated in prostate are extremely rare, with <20 cases described in the literature. We report a case of a patient with a primary prostatic mixed EGGCT. A 47-year-old man presenting severe low urinary tract symptoms and signs of prostatic enlargement, with no malignancy suspicion, underwent transurethral resection of the prostate. The histopathological evaluation suggested the diagnosis of a retroperitoneal sarcoma. The patient underwent neoadjuvant chemotherapy and then was submitted to radical cystoprostatectomy. Histology revealed a mixed EGGCT of the prostate with yolk sac tumour and seminoma components. No testicular abnormalities were identified on the postoperative scrotal ultrasound. The patient went through four cycles of chemotherapy with bleomycin, etoposide and cisplatin. After 12 months of follow-up, the patient is alive and free of recurrence.
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Affiliation(s)
- Hugo Pontes Antunes
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Rui Almeida
- Department of Pathology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Vítor Sousa
- Department of Pathology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Arnaldo Figueiredo
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
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Türkoğlu AR, Coban S, Guzelsoy M, Demirbas M, Mutlu N, Yalcin O. Rare late metastasis of testis seminoma to the bladder. Can Urol Assoc J 2015; 9:E823-5. [PMID: 26600894 DOI: 10.5489/cuaj.3250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 45-year-old male presented to our clinic with complaining of hematuria for a month. The investigations showed a 59 × 24-mm myxoid mass on the right lateral bladder wall and this was removed with transurethral resection. The histopathology evaluation result was seminoma (classic type). The medical history revealed that the patient had undergone inguinal orchiectomy for a testis tumour 10 years before and the diagnosis was classic type seminoma. He received chemotherapy following the orchiectomy, but had not gone for follow-up after the first year. There was no other metastasis and he was put on the iphosphamide, etoposide, cisplatin (IPE) protocol. The patient has been disease-free for the last 5 months and the tumour markers and cystoscopy were normal. Testis tumours can rarely cause other organ metastases in the late stage even if curative surgery and chemo-radiotherapy were initially administered. Proper follow-up is crucial. It is also necessary to query the tumour history when a tumour in any organ is considered.
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Affiliation(s)
| | - Soner Coban
- Şevket Yılmaz Educational and Research Hospital, Bursa, Turkey
| | | | - Murat Demirbas
- Şevket Yılmaz Educational and Research Hospital, Bursa, Turkey
| | - Nazmi Mutlu
- Şevket Yılmaz Educational and Research Hospital, Bursa, Turkey
| | - Omer Yalcin
- Şevket Yılmaz Educational and Research Hospital, Bursa, Turkey
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Zheng W, Wang L, Yang D, Fang K, Chen X, Wang X, Li X, Li Z, Song X, Wang J. Primary extragonadal germ cell tumor: A case report on prostate seminoma. Oncol Lett 2015; 10:2323-2326. [PMID: 26622843 DOI: 10.3892/ol.2015.3592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 07/07/2015] [Indexed: 01/01/2023] Open
Abstract
Primary extragonadal germ cell tumors are rare, and 60% of such cases are seminomas. While the tumors can occur in the mediastinum, thymus, retroperitoneal organs and pineal gland, seminoma originating in the prostate tissue is extremely rare. The present study reports the case of a 54-year-old male with prostate seminoma. The patient was followed up at the First Affiliated Hospital of Dalian Medical University (Dalian, Liaoning, China) from 2001 onwards. The patient received chemotherapy with cyclophosphamide following total resection of the pelvic organs, pelvic lymph node dissection, continent detenial cecum-ascending colic bladder and orchidectomy. The patient experienced considerable post-operative quality of life for >10 years and the disease did not reappear. The study indicated that extragonadal seminoma is sensitive to chemotherapy, and that radical surgery and post-operative adjuvant chemotherapy with cyclophosphamide is a reasonable and feasible treatment method.
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Affiliation(s)
- Wei Zheng
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Lina Wang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Deyong Yang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Kun Fang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xiaochi Chen
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xuejian Wang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xiancheng Li
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Ziyao Li
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xishuang Song
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Jianbo Wang
- Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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[Incidental undifferentiated carcinoma of the prostate: A case with unusual diagnosis]. Urologe A 2014; 54:1602-5. [PMID: 25301238 DOI: 10.1007/s00120-014-3650-x] [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: 10/24/2022]
Abstract
A 69-year-old man presented with an incidental undifferentiated carcinoma of the prostate. Ten years ago the patient had clinical stage I seminoma of the right testis with adjuvant radiotherapy. Follow-up care was without pathological findings. Staging examinations did not show metastatic disease. After radical prostatectomy with pelvic lymphadenectomy, the histological examination revealed a metastatic seminoma in the prostate. Therefore, the diagnosis was a late relapse in an extremely rare location. So far only four other reports describe testicular seminoma with metastases to the prostate.
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Abstract
Non-epithelial prostatic neoplasms are infrequent and cover a broad array of entities that include both benign and highly aggressive tumours. Because they are very infrequent, there is often limited understanding of them, and the recognition of these entities, when encountered, may pose a diagnostic challenge, owing to histological overlap between them or their rarity. Most lesions in this category are mesenchymal in origin, such as prostatic stromal tumours arising from specialized prostatic stroma, smooth muscle tumours, both benign and malignant, and solitary fibrous tumours. Less commonly occurring tumours include neural, germ cell and melanocytic tumours that may be derived from cells not normally present in the prostate. Some tumours have well-established extraprostatic counterparts and, when encountered, are more commonly extraprostatic/secondary in origin; these include gastrointestinal stromal tumours and most haematopoietic tumours. The majority of tumours are characterized by a spindle cell pattern with significant overlap in morphological features. In this setting, appropriate use of immunohistochemistry and molecular studies are often necessary for accurate diagnosis, prognosis, or prediction for therapy. This review addresses and updates the clinicopathological features of the entire spectrum of non-epithelial tumours with an approach to the histological diagnosis.
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Affiliation(s)
- Gladell P Paner
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Kuno T, Shinohara T, Kasahara K, Matsuoka A, Komatsu Y, Naruse K, Watanabe H. Extragonadal seminoma presenting as a large mass in the pelvic cavity without c-kit-activating mutations. Jpn J Clin Oncol 2012; 42:650-3. [PMID: 22581924 DOI: 10.1093/jjco/hys065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Extragonadal germ cell tumors are relatively rare tumors, which usually occur in the mediastinum or retroperitoneum. In this report, we present a case of primary seminoma arising in the pelvic cavity. A 58-year-old man with urinary retention and abdominal distension was admitted to our hospital. Computed tomography and magnetic resonance imaging demonstrated a large mass in the pelvic cavity. Histological examination of the specimens obtained by open biopsy revealed seminomatous malignant cells. Immunohistochemical studies detected vimentin, placental alkaline phosphatase and c-kit. Taking these results together with the patient's other clinical manifestations, this case was diagnosed as extragonadal seminoma without c-kit-activating mutations, and chemotherapy followed by radiation therapy was successful. Primary seminoma in the pelvic cavity is extremely rare, but should be considered a cause of pelvic mass formation.
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Affiliation(s)
- Takahira Kuno
- Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan
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Abstract
Primary seminoma of the prostate is extremely rare. We describe a case of a 35-year-old man who presented with difficulty in urinating. Physical findings were unremarkable, but a rectal examination revealed a slightly hardened prostate with a nodule in the right lobe. Blood parameters were normal; however, blood chemistry revealed slightly elevated lactic dehydrogenase, and microscopic hematuria was evident. Serum prostate acid phosphate, carcinoembryonic antigen, and alpha-fetoprotein values were within normal limits. Both computed tomography and magnetic resonance images revealed a large mass in the prostate gland. A prostatic sarcoma or malignant lymphoma was initially suspected. A systemic survey using 18-fluoro-2-deoxyglucose (F-18 FDG) positron emission tomography revealed focal FDG uptake in the prostate gland. A prostatic biopsy of the mass was histologically diagnosed to reveal an extragonadal seminoma.
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