1
|
Oyogoa E, Sonpatki M, Brinkerhoff BT, Andeen N, Meyer H, Ryan C, Sokolova AO. Mixed Adenosquamous Cell Carcinoma of the Prostate with Paired Sequencing on the Primary and Liver Metastasis. Curr Oncol 2024; 31:2393-2399. [PMID: 38785459 PMCID: PMC11119923 DOI: 10.3390/curroncol31050178] [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: 02/15/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 05/25/2024] Open
Abstract
This report aims to shed light on the intricate challenges encountered during the diagnosis and treatment of an uncommon variant of prostate cancer-mixed adenosquamous cell carcinoma of the prostate. Prostate cancers of this nature pose distinctive diagnostic and therapeutic dilemmas due to their rarity and complex histological composition. We present a case of a 63-year-old man with metastatic prostate cancer, featuring adenocarcinoma with squamous cell differentiation, who underwent a multimodal treatment approach. The patient responded to first-line carboplatin, docetaxel, and androgen deprivation therapy, followed by androgen receptor pathway inhibitor (ARPI) maintenance. However, disease progression led to radiation therapy and a subsequent switch to Lutetium (177Lu) vipivotide tetraxetan after chemotherapy challenges. Comprehensive genetic profiling revealed shared mutations in the prostate and liver lesions, emphasizing the role of targeted therapies. Prostate-specific membrane antigen (PSMA)-targeted therapy resulted in a notable PSA decline. This case highlights the evolving treatment landscape for rare prostate cancers, integrating genetic insights for tailored interventions. In conclusion, squamous cell carcinoma (SCC) of the prostate is rare, emphasizing the imperative for enhanced comprehension in diagnosis and management. Our case suggests the potential efficacy of ARPI and PSMA-targeted therapies. Our findings advocate for a more nuanced approach to the management of this rare prostate cancer variant, leveraging genomic insights for personalized treatment strategies. This exploration serves as a foundation for further research and clinical considerations in addressing the challenges posed by mixed adenosquamous cell carcinoma of the prostate.
Collapse
Affiliation(s)
- Emmanuella Oyogoa
- Department of Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Maya Sonpatki
- Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA
| | - Brian T. Brinkerhoff
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nicole Andeen
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Haley Meyer
- Department of Internal Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Christopher Ryan
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Alexandra O. Sokolova
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Sciences University, Portland, OR 97239, USA
| |
Collapse
|
2
|
Li P, Haines GK, Si Q, Baskovich B. Post-therapeutic squamous cell transformation of a metastatic prostate adenocarcinoma with comparison of molecular profiles: a case report and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2024; 17:78-82. [PMID: 38577694 PMCID: PMC10988092 DOI: 10.62347/zqci9925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/20/2024] [Indexed: 04/06/2024]
Abstract
Transformation of primary prostate adenocarcinoma to squamous cell carcinoma after initial treatment with chemotherapy and hormonal therapy is extremely rare and typically results in rapid treatment-refractory disease progression and death. Here, we present a case of a 64-year-old man who was initially diagnosed with metastatic prostate adenocarcinoma (positive PSA and NKX3.1 stains, total PSA 747.2 ng/ml) to the thoracic spine (T8) in 2019. The patient received androgen deprivation therapy and chemotherapy with good response (PSA 2.53 ng/ml). In 2022, the patient had a tumor resection from the left humerus with a consequent fracture. Pathology showed pure squamous carcinoma without any adenocarcinoma component (PSA and NKX3.1 stains negative and weak p504s stain, PSA 19.82 ng/ml). Given the patient's history of metastatic prostate adenocarcinoma and no history of any other malignancies, a diagnosis of squamous carcinoma transformed from prostate adenocarcinoma was rendered. The patient passed away in 2023. Molecular profiling identified the same TP53 mutation and two variants of uncertain significance in both specimens, suggesting the same primary. However, there was CCND3 amplification and absence of the TMPRSS2::ETV4 fusion in the 2022 specimen, which may be associated with squamous transformation and poor prognosis. A microarray might be beneficial to confirm loss of the TMPRSS2::ETV4 fusion. This case illustrates the rare occurrence of squamous transformation in prostate adenocarcinoma and the aggressive clinical course, and need for more therapy guidance and prognostic studies. It also highlights the importance of molecular profiling to provide insights into the pathogenesis of histologic transformation.
Collapse
Affiliation(s)
- Peizi Li
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai New York, NY, USA
| | - George K Haines
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai New York, NY, USA
| | - Qiusheng Si
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai New York, NY, USA
| | - Brett Baskovich
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai New York, NY, USA
| |
Collapse
|
3
|
Yang J, Xiao L, Gao X, Tang Y, Hu S. Primary Adenosquamous Carcinoma of the Prostate With Multiple Heterogenic Metastases Demonstrated on 68 Ga-PSMA and 18 F-FDG PET/CT Imaging. Clin Nucl Med 2024; 49:180-181. [PMID: 38049966 DOI: 10.1097/rlu.0000000000004990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
ABSTRACT A 54-year-old man presented with a 2-month history of urination disturbances. Serum prostate-specific antigen level was 4.96 ng/mL, and a possibility of benign prostate hyperplasia was raised by outside medical CT. Histopathology revealed adenosquamous carcinoma. Staging workup showed large areas of high PSMA uptake and focal intense hypermetabolism in the prostate, multiple lymphatics, bone, and pulmonary heterogenic metastases on 68 Ga-PSMA and 18 F-FDG PET/CT imaging.
Collapse
Affiliation(s)
| | - Ling Xiao
- From the Department of Nuclear Medicine
| | - Xiaomei Gao
- Department of Pathology, National Clinical Research Center for Geriatric Disorders
| | | | | |
Collapse
|
4
|
Alasker A, Shafqat A, Sabbah BN, Alghafees M, Al Saud AA, Aljabi N, Altaweel KM, Alhumaidan R, Musalli ZF, Almanie A, Abu Alqam R, Bin Ofisan S. Beyond the norm: exploring the uncommon squamous cell carcinoma of the prostate using a Saudi tumor registry. Ann Med Surg (Lond) 2023; 85:5869-5873. [PMID: 38098589 PMCID: PMC10718388 DOI: 10.1097/ms9.0000000000001220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/12/2023] [Indexed: 12/17/2023] Open
Abstract
Background Squamous cell carcinoma (SCC) of the prostate has limited treatment choices and portends a dismal prognosis with an average survival time of ~14-months. This study provides a descriptive overview of SCC of the prostate in Saudi Arabia. Materials and Methods A retrospective cohort study of patients diagnosed with prostatic SCC between 1 January 2008 and 31 December 2017. Information on demographic and tumor characteristics and the survival of patients was collected from the Saudi Cancer Registry. Survival was depicted through Kaplan-Meier plots. Fisher's exact test was used to assess the association between categorical variables and death, while a Wilcoxon rank sum test was applied for numerical variables. Results Out of a larger subset of 3607 patients, 16 patients were diagnosed with prostatic SCC, of which half resided in the Central region (50.0%) and most (81.2%) were aged greater than or equal to 60 years. Most patients (62.6%) had poorly differentiated (grade III, 43.8%) lesions, and 50% of cases were metastatic at diagnosis. 62.5% of patients died, all residing in the Eastern and Central regions. Regional extension (75.0%) and distant metastasis (87.5%) were significantly associated with death compared to localized lesions (0.0%) (P=0.022). The 5-year survival rate in our study was 33%. Conclusion The present study is the first to describe the characteristics of prostatic SCC in Saudi Arabia. Our results are consistent with prior studies showing that prostatic SCC is often high-grade and metastatic at diagnosis, conferring a poor prognosis.
Collapse
Affiliation(s)
- Ahmed Alasker
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
- King Abdulaziz Medical City
- King Abdullah International Medical Research Center
| | | | | | - Mohammad Alghafees
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | | | | | | | | | | | | | | | - Salman Bin Ofisan
- College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| |
Collapse
|
5
|
Autio K, McBride S. Oligometastatic Squamous Cell Transformation From Metastatic Prostate Adenocarcinoma Treated With Systemic and Focal Therapy: A Case Report. JOURNAL OF IMMUNOTHERAPY AND PRECISION ONCOLOGY 2022; 5:79-83. [PMID: 36034583 PMCID: PMC9390704 DOI: 10.36401/jipo-22-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/24/2022] [Accepted: 04/11/2022] [Indexed: 11/09/2022]
Abstract
ABSTRACT
Transformation to squamous cell carcinoma (SCC) after initial treatment of a primary prostate adenocarcinoma is rare and typically results in rapid treatment-refractory disease progression and death. Here, we present a case of a 70-year-old man who was initially treated with prostatectomy and radiotherapy, and later developed bone metastases. After commencing systemic therapy with androgen deprivation therapy (ADT) and apalutamide, his prostate-specific antigen (PSA) declined to undetectable levels, yet short-interval imaging demonstrated oligo-progression at T4, with biopsy specimen demonstrating pure SCC. Molecular profiling of both the primary prostate tumor and T4 demonstrated alterations in TMPRSS2-ERG, TP53, and FOXA1 confirming site of origin, with loss of RNF43 in the squamous metastasis. He was treated with stereotactic body radiation therapy to the SCC metastasis and continued on ADT and apalutamide with stable disease for a year post-radiation. This case highlights the importance of imaging to detect non–PSA-producing metastatic disease, the utility of radiation therapy in oligo-progression, and use of molecular profiling to provide insights into the pathogenesis of histologic transformation.
Collapse
Affiliation(s)
- Karen Autio
- 1 Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sean McBride
- 2 Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
6
|
Matsugasumi T, Masui K, Yamada K, Watanabe S, Okihara K, Kozawa N, Yamada Y, Yamazaki H, Yamada K, Ukimura O. Challenge and Outcome for the Prostate Squamous Cell Carcinoma Which Developed 8 Years after Low-Dose-Rate Brachytherapy Approached by a Combined Multimodal Treatment with High-Dose-Rate Interstitial Brachytherapy, External Beam Radiation Therapy, and Chemotherapy. Case Rep Oncol 2021; 14:854-860. [PMID: 34248551 PMCID: PMC8255723 DOI: 10.1159/000516034] [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] [Received: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 11/23/2022] Open
Abstract
Prostate squamous cell carcinoma (pSCC) rarely develops as a secondary cancer after treatment with low-dose-rate brachytherapy (LDR-BT). There is no established effective treatment for the disease condition. Herein, we present a 78-year-old man who developed pSCC 8 years after LDR-BT. He was subsequently selected to receive a combined multimodal treatment with high-dose-rate interstitial brachytherapy (HDR-ISBT), external beam radiation therapy, and chemotherapy for his pSCC. Eleven months later, he displayed no biochemical failure nor clinical radiographic recurrence. However, MRI detected a newly developed prostatic-rectal fistula (grade 4), and a colostomy was performed to relieve pain and inflammation. To our knowledge, this is the first report to perform a combined multimodal treatment with HDR-ISBT for pSCC suspected as a secondary cancer due to LDR-BT.
Collapse
Affiliation(s)
- Toru Matsugasumi
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Urology, Kyoto Kidugawa Hospital, Kyoto, Japan
| | - Koji Masui
- Department of Radiation Oncology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Kaori Yamada
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sho Watanabe
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Okihara
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Urology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nana Kozawa
- Department of Radiology, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Yasuhiro Yamada
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideya Yamazaki
- Department of Radiation Oncology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Kei Yamada
- Department of Radiation Oncology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
7
|
de Brot S, Lothion-Roy J, Grau-Roma L, White E, Guscetti F, Rubin MA, Mongan NP. Histological and immunohistochemical investigation of canine prostate carcinoma with identification of common intraductal carcinoma component. Vet Comp Oncol 2021; 20:38-49. [PMID: 33963663 PMCID: PMC9292867 DOI: 10.1111/vco.12704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 03/31/2021] [Accepted: 05/06/2021] [Indexed: 12/03/2022]
Abstract
A limited number of species, including men and dogs, spontaneously develop prostate cancer (PC). The histological and molecular relevance of canine PC as a model for the disease in men remains controversial. To address this challenge, this study aimed to assess the histomorphology and expression of basal cell, urothelial and neuroendocrine markers [p63, high molecular weight cytokeratin (HMWCK), Uroplakin 3 (UPIII), neuron‐specific enolase (NSE)] in canine PC (n = 41). Based on histomorphology, 10/41 (24%), 21/41 (51%) and 9/41 (22%) were classified as adenocarcinoma (AC), urothelial carcinoma (UC), and mixed carcinoma, respectively. Tumour inflammation was common, frequently severe [20/41 (49%)], and associated with neutering (p < .02) and urothelial differentiation (p < .02). Most (36/40, 90%) cancers contained only rare cells with basal cell marker expression or were negative. The expression of UPIII was absent or weak in the majority (33/38, 87%) of tumours, with moderate to strong staining in the remaining cases. NSE expression in PC was rare and limited to 2/14 (14%) cases. Tumour extension into benign ducts and glands was a common finding with presence in 17/39 (44%) of carcinomas with and without urothelial differentiation. In conclusion, we confirm that canine PC is characterized by absent or weak expression of basal cell and urothelial markers. Although rare, NSE expression, potentially indicating neuroendocrine differentiation, is reported for the first time in canine PCa. Intraductal carcinoma of the prostate with concurrent invasive PCa (IDCP‐inv) is a frequent, not previously described, finding in dogs with PC.
Collapse
Affiliation(s)
- Simone de Brot
- COMPATH, Institute of Animal Pathology, University of Bern, Bern, Switzerland.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Jennifer Lothion-Roy
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.,BioDiscovery Institute, University of Nottingham, Nottingham, UK
| | - Llorenç Grau-Roma
- COMPATH, Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - Emily White
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Franco Guscetti
- Institute of Veterinary Pathology, University of Zurich, Zurich, Switzerland
| | - Mark A Rubin
- Department of BioMedical Research, University of Bern, Bern, Switzerland.,Bern Center for Precision Medicine, University of Bern and Inselspital, Bern, Switzerland
| | - Nigel P Mongan
- BioDiscovery Institute, University of Nottingham, Nottingham, UK.,Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
8
|
Hutten RJ, Weil CR, Tward JD, Lloyd S, Johnson SB. Patterns of Care and Treatment Outcomes in Locoregional Squamous Cell Carcinoma of the Prostate. EUR UROL SUPPL 2021; 23:30-33. [PMID: 34337486 PMCID: PMC8317810 DOI: 10.1016/j.euros.2020.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/28/2022] Open
Abstract
Primary squamous cell carcinoma is a rare, aggressive disease with historically poor outcomes and no established treatment guidelines. Case reports are limited but describe multiple treatment approaches. Seeking to identify practice patterns and treatment outcomes, we used the US National Cancer Data Base to identify 66 males with locoregional primary squamous cell carcinoma of the prostate treated with surgery, chemotherapy, and/or radiotherapy between 2004 and 2015. Patients were stratified into treatment groups consisting of local therapy alone (n = 40; 61%), local therapy and chemotherapy (n = 13; 20%), chemotherapy alone (n = 7; 11%), and observation (n = 6; 9%). Patients with clinical stage T3–T4 disease were significantly more likely to receive combined chemotherapy and local therapy on multivariable analysis. Median survival was 20 mo for patients treated with local therapy alone, 37 mo with local therapy and chemotherapy, and 11 mo with chemotherapy alone. Overall survival was not significantly different between treatment groups. Despite limitations in sample size, these data suggest that addition of chemotherapy to local therapy is a reasonable treatment approach for select patients. Patient summary Squamous cell carcinoma of the prostate is an extremely rare disease. Our review of patterns of care using data from the National Cancer Data Base shows inconsistent use of combined local and systemic therapy. The small sample size for this rare disease limits any conclusions regarding survival differences, but the data suggest that a combination approach using chemotherapy in addition to surgery or radiation is a reasonable treatment option for disease confined to the prostate.
Collapse
Affiliation(s)
- Ryan J Hutten
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Christopher R Weil
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Jonathan D Tward
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Shane Lloyd
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Skyler B Johnson
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| |
Collapse
|
9
|
Hanna K, Lele SM, McCormick G, McMahon A, Hill B, Boyle SL. Primary prostatic squamous cell carcinoma. Urol Case Rep 2020; 34:101478. [PMID: 33235827 PMCID: PMC7670195 DOI: 10.1016/j.eucr.2020.101478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/21/2022] Open
Abstract
Primary prostate squamous cell malignancies are rare and very aggressive. A 65-year-old man presented to our institution with clinical and radiographic findings concerning for advanced prostatic malignancy. Surgical pathology of the tumor revealed poorly differentiated carcinoma with squamous differentiation, and histopathological markers were positive for markers of squamous differentiation negative for all urothelial and prostatic markers.
Collapse
Affiliation(s)
- Kevin Hanna
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
- Corresponding author
| | - Subodh M. Lele
- Department of Pathology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE 68198-3135, United States
| | - Grant McCormick
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Amber McMahon
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Brett Hill
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, 984110 Nebraska Medical Center, Omaha, NE 68198-4110, United States
| | - Shawna L. Boyle
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, 984110 Nebraska Medical Center, Omaha, NE 68198-4110, United States
- Corresponding author.
| |
Collapse
|
10
|
Abstract
Prostate adenocarcinoma is the most common prostate cancer; however, there are several other malignant neoplasms that radiologists should be familiar with. The histological classification of malignant prostate neoplasms includes epithelial tumors, mesenchymal tumors, neuroendocrine tumors, hematolymphoid tumors, and stromal tumors. Knowledge of the main clinical and prostate magnetic resonance imaging features of uncommon tumors beyond adenocarcinoma is important for radiologists to enlarge their diagnostic ability and guide referring physician regarding the appropriate patient workup.The aim of this review article is to (1) review the main anatomical and histological concepts of the prostate gland and (2) provide an overview of uncommon prostate malignant neoplasms, emphasizing the key clinical, pathological, and imaging findings that may help radiologists in their daily interpretation of prostate magnetic resonance imaging.
Collapse
|
11
|
Lau HD, Clark M. Metastatic squamous cell carcinoma transformed from prostatic adenocarcinoma following androgen deprivation therapy: A case report with clinicopathologic and molecular findings. Diagn Cytopathol 2020; 48:E14-E17. [PMID: 32628337 DOI: 10.1002/dc.24539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/16/2020] [Indexed: 12/21/2022]
Abstract
Squamous cell carcinoma (SCC) of the prostate is a rare and clinically aggressive entity that may arise de novo or through transformation of prostatic adenocarcinoma, typically following hormonal or radiation therapy. Confirmation of prostatic origin, especially when evaluating a metastatic focus, often requires correlation with clinical and imaging findings, as the morphologic and immunohistochemical features of SCC are not organ-specific. Comprehensive genomic profiling (CGP) may provide additional information useful for confirming the primary site and for identifying potential targeted therapy options. CGP data may also contribute to our understanding of the molecular basis of squamous differentiation in prostatic malignancies. However, these data are limited, and to our knowledge, there are only three previously published cases of prostatic SCC with reported CGP findings. Herein, we report a case of metastatic keratinizing SCC diagnosed by core needle biopsy in a 68-year-old man with a history of prostatic adenocarcinoma status post radical prostatectomy and androgen deprivation therapy (ADT). NKX3.1 immunohistochemistry was negative. CGP was performed, and a TMPRSS2-ERG fusion, among other genetic alterations, was detected, supporting a diagnosis of metastatic SCC transformed from prostatic adenocarcinoma following ADT. This case supports the use of CGP or other molecular techniques not only to query potential targeted therapy options but also to refine the diagnosis and confirm the primary site of disease in cases with non-specific morphologic and immunophenotypic features, such as SCC.
Collapse
Affiliation(s)
- Hubert D Lau
- VA Palo Alto Health Care System, Pathology and Laboratory Service, Palo Alto, California, USA
| | - Melissa Clark
- VA Palo Alto Health Care System, Pathology and Laboratory Service, Palo Alto, California, USA
| |
Collapse
|
12
|
Matsugasumi T, Nakanishi H, Yokota T, Shiraishi T, Ukimura O. Prostate squamous cell carcinoma developing 11 years after external radiotherapy for prostate adenocarcinoma. IJU Case Rep 2020; 3:121-124. [PMID: 33392467 PMCID: PMC7770592 DOI: 10.1002/iju5.12161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/20/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Secondary bladder, colon, and rectal cancers are relatively common after prostate radiotherapy. However, secondary squamous cell carcinoma of the prostate is rare. CASE PRESENTATION An 85-year-old man presented with dysuria and low-serum prostate-specific antigen levels. His medical history included localized prostate adenocarcinoma (Gleason score of 4 + 5) treated with combined three-dimensional conformal radiotherapy and androgen deprivation therapy, 11 years ago. Urethroscopy and magnetic resonance imaging showed a bulging mass around the prostatic urethra. Transurethral resection of the prostate performed for histopathological diagnosis revealed squamous cell carcinoma. CONCLUSION Hereby, a rare case of secondary squamous cell carcinoma of the prostate after radiotherapy for adenocarcinoma was reported, which was found after 11 years of radiotherapy with symptom of dysuria including urinary hesitancy, difficulty, pain during urination, and low-serum prostate-specific antigen levels.
Collapse
Affiliation(s)
- Toru Matsugasumi
- Department of UrologyKyoto Chubu Medical CenterNantan CityKyotoJapan
- Department of UrologyKyoto Prefectural University of MedicineKyotoJapan
| | | | - Tomohiro Yokota
- Department of UrologyKyoto Chubu Medical CenterNantan CityKyotoJapan
| | - Takumi Shiraishi
- Department of UrologyKyoto Prefectural University of MedicineKyotoJapan
| | - Osamu Ukimura
- Department of UrologyKyoto Prefectural University of MedicineKyotoJapan
| |
Collapse
|
13
|
European Association of Urology Guidelines on Primary Urethral Carcinoma-2020 Update. Eur Urol Oncol 2020; 3:424-432. [PMID: 32605889 DOI: 10.1016/j.euo.2020.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/30/2020] [Accepted: 06/10/2020] [Indexed: 01/10/2023]
Abstract
CONTEXT Primary urethral carcinoma (PUC) is a rare cancer accounting for <1% of all genitourinary malignancies. OBJECTIVE To provide updated practical recommendations for the diagnosis and management of PUC. EVIDENCE ACQUISITION A systematic search interrogating Ovid (Medline), EMBASE, and the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was performed. EVIDENCE SYNTHESIS Urothelial carcinoma of the urethra is the predominant histological type of PUC (54-65%), followed by squamous cell carcinoma (16-22%) and adenocarcinoma (10-16%). Diagnosis of PUC depends on urethrocystoscopy with biopsy and urinary cytology. Pathological staging and grading are based on the tumour, node, metastasis (TNM) classification and the 2016 World Health Organization grading systems. Local tumour extent and regional lymph nodes are assessed by magnetic resonance imaging, and the presence of distant metastases is assessed by computed tomography of the thorax/abdomen and pelvis. For all patients with localised distal tumours (≤T2N0M0), partial urethrectomy or urethra-sparing surgery is a valid treatment option, provided that negative intraoperative surgical margins can be achieved. Prostatic Ta-Tis-T1 PUC can be treated with repeat transurethral resection of the prostate and bacillus Calmette-Guérin. In prostatic or proximal ≥ T2N0 disease, neoadjuvant cisplatin-based chemotherapy should be considered prior to radical surgery. All patients with locally advanced disease (≥T3N0-2M0) should be discussed within a multidisciplinary team. In men with locally advanced squamous cell carcinoma, curative radiotherapy combined with radiosensitising chemotherapy can be offered for definitive treatment and genital preservation. In patients with local urethral recurrence, salvage surgery or radiotherapy can be offered. For patients with distant metastatic disease, systemic therapy based on tumour characteristics can be evaluated. CONCLUSIONS These updated European Association of Urology guidelines provide up-to-date guidance for the contemporary diagnosis and management of patients with suspected PUC. PATIENT SUMMARY Primary urethral carcinoma (PUC) is a very rare, but aggressive disease. These updated European Association of Urology guidelines provide evidence-based guidance for clinicians treating patients with PUC.
Collapse
|
14
|
Mathew G, Trotman LC. Competence against insufficiency: Why are men mostly safe from a rare and deadly prostate cancer? J Exp Med 2020; 217:e20200087. [PMID: 32236496 PMCID: PMC7971130 DOI: 10.1084/jem.20200087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Prostate cancer is a slow-growing disease, but not always. A highly rare and lethal form of the disease shows survival rates of less than a year. It is called squamous cell prostate carcinoma. In this issue of JEM, Hermanova et al. (https://doi.org/10.1084/jem.20191787) provide new findings in mouse demonstrating a strong genetic handle on both the reasons behind the rarity and the aggressiveness.
Collapse
|
15
|
Dizman N, Salgia M, Ali SM, Wu H, Arvanitis L, Chung JH, Pal SK. Squamous Transformation of Prostate Adenocarcinoma: A Report of Two Cases With Genomic Profiling. Clin Genitourin Cancer 2019; 18:e289-e292. [PMID: 31882336 DOI: 10.1016/j.clgc.2019.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nazli Dizman
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Meghan Salgia
- Miller School of Medicine, University of Miami, Miami, FL
| | | | - Huiqing Wu
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Leonidas Arvanitis
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
| |
Collapse
|
16
|
D'Angelo JT, Bhaskar N, Friedes C, Husain M. Post-Brachytherapy Transformation of Prostatic Adenocarcinoma to Squamous Cell Carcinoma: A Cadaver Anatomy Case Report. Cureus 2019; 11:e6184. [PMID: 31890390 PMCID: PMC6913902 DOI: 10.7759/cureus.6184] [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: 12/03/2022] Open
Abstract
Prostatic squamous cell carcinoma comprises less than 1% of reported prostate cancers. This form of cancer has a poor prognosis with a low survival time following diagnosis and no definitive form of treatment. A Caucasian male cadaver presented with primary pure squamous cell carcinoma of the prostate with metastasis to the liver and local invasion of the bladder, ureter, and rectum. Post-mortem examination showed evidence of brachytherapy radiation seeds in the prostate. Histological analysis and clinical intuition suggest that these seeds were used in an attempt to treat a previous low-grade adenocarcinoma of the prostate. The lack of patient history complicates determining a definitive cause of death, but the pathological presentation strongly suggests that the cause of death was a pure squamous cell carcinoma of the prostate following brachytherapy treatment for a previous prostatic adenocarcinoma. This case report further aids in establishing the relationship between the use of brachytherapy for prostatic adenocarcinoma and the subsequent development of prostatic squamous cell carcinoma.
Collapse
Affiliation(s)
- John T D'Angelo
- Medicine, University of Central Florida College of Medicine , Orlando, USA
| | - Neha Bhaskar
- Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Cole Friedes
- Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Mujtaba Husain
- Pathology, University of Central Florida College of Medicine, Orlando, USA
| |
Collapse
|
17
|
Ichaoui H, Nasr SB, Gargouri F, Zribi A, Hermi A, Fendri S, Balti M, Ayari J, Khiari R, Msakni I, Mansouri N, Ghozzi S, Haddaoui A. Transformation of a prostatic adenocarcinoma into squamous cell carcinoma after luteinizing hormone-releasing hormone (LHRH) agonist and radiotherapy treatment. Pan Afr Med J 2019; 34:125. [PMID: 33708294 PMCID: PMC7906544 DOI: 10.11604/pamj.2019.34.125.19421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/29/2019] [Indexed: 11/11/2022] Open
Abstract
Squamous cell carcinoma of the prostate is rare and represents 0.5% to 1% of prostatic carcinomas. Transformation of prostatic adenocarcinoma into squamous cell carcinoma after LH-RH agonist intake has been reported in only 8 cases in the literature. To our knowledge, our case is the second pure squamous cell carcinoma observed after hormonotherapy and radiotherapy. We reported a case of a patient with prostatic adenocarcinoma treated by radical prostatectomy followed by radiotherapy. Eleven years later, he had a vesical recurrence of prostatic adenocarcinoma. Our patient had an endoscopic resection followed by injections of Triptorelin. Six months later, he developed a local recurrence of a squamous cell carcinoma.
Collapse
Affiliation(s)
- Hamza Ichaoui
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Urology, Montfleury 1008, Tunis, Tunisia
| | - Sonia Ben Nasr
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| | - Faten Gargouri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Pathology, Montfleury 1008, Tunis, Tunisia
| | - Aref Zribi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| | - Amine Hermi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Urology, Montfleury 1008, Tunis, Tunisia
| | - Sana Fendri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| | - Mehdi Balti
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| | - Jihen Ayari
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| | - Ramzi Khiari
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Urology, Montfleury 1008, Tunis, Tunisia
| | - Issam Msakni
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Pathology, Montfleury 1008, Tunis, Tunisia
| | - Nada Mansouri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Pathology, Montfleury 1008, Tunis, Tunisia
| | - Samir Ghozzi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Urology, Montfleury 1008, Tunis, Tunisia
| | - Abderrazek Haddaoui
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,The Military Hospital of Tunis, Department of Medical Oncology, Montfleury 1008, Tunis, Tunisia
| |
Collapse
|
18
|
Shanks JH, Srigley JR, Brimo F, Comperat E, Delahunt B, Koch M, Lopez‐Beltran A, Reuter VE, Samaratunga H, Tsuzuki T, Kwast T, Varma M, Grignon D. Dataset for reporting of carcinoma of the urethra (in urethrectomy specimens): recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2019; 75:453-467. [DOI: 10.1111/his.13877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jonathan H Shanks
- Department of Histopathology The Christie NHS Foundation Trust Manchester UK
| | - John R Srigley
- Department of Laboratory Medicine and Pathobiology University of Toronto Toronto ON Canada
| | - Fadi Brimo
- McGill University Health Center Montréal QC Canada
| | - Eva Comperat
- Department of Pathology Hospital Tenon, HUEP, Sorbonne University Paris France
| | - Brett Delahunt
- Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences University of Otago Wellington New Zealand
| | - Michael Koch
- Department of Urology Indiana University School of Medicine Indianapolis IN USA
| | | | - Victor E Reuter
- Department of Pathology Memorial Sloan Kettering Cancer Center New York NY USA
| | - Hemamali Samaratunga
- Aquesta Specialized Uropathology Brisbane Qld, Australia
- Centre for Clinical Research The University of Queensland Brisbane Qld, Australia
- Princess Alexandra Hospital Brisbane Qld Australia
| | | | - Theo Kwast
- Laboratory Medicine Program University Health Network, University of Toronto Toronto ON Canada
| | - Murali Varma
- Department of Cellular Pathology University Hospital of Wales Cardiff UK
| | - David Grignon
- IUH Pathology Laboratory, Department of Pathology and Laboratory Medicine Indiana University School of Medicine Indianapolis IN USA
| |
Collapse
|
19
|
Lee J. Transformation of adenocarcinoma of prostate to squamous cell carcinoma following hormonal treatment: A case report and review of the literature. Radiol Case Rep 2019; 14:483-489. [PMID: 30805072 PMCID: PMC6374616 DOI: 10.1016/j.radcr.2019.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/26/2019] [Indexed: 10/28/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the prostate is a rare tumor with aggressive nature. This type of tumor has a poor response to conventional treatment and results in poor prognosis. Squamous differentiation or metaplasia may arise subsequent to endocrine or radiation treatment, but it is very rare. To date, a few cases have been reported in the literature. Due to its rarity, the radiologic findings of SCC of the prostate are not well established. We describe a case of SCC of the prostate developing in a patient with adenocarcinoma of the prostate following hormonal therapy. Furthermore, we review the imaging features of this rare disease across multiple imaging modalities.
Collapse
Affiliation(s)
- Jihyun Lee
- Department of Radiology, Donnam Institute of Radiological and Medical Science, 40, Jwadong-gil, Jangan-eup, Gijang-gun, Busan 46033, Republic of Korea
| |
Collapse
|
20
|
The association between personal income and aging: A population-based 13-year longitudinal study. Arch Gerontol Geriatr 2017; 70:76-83. [DOI: 10.1016/j.archger.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 12/23/2016] [Accepted: 01/02/2017] [Indexed: 11/22/2022]
|
21
|
Bahloul A, Charfi S, Franck F, Jung J. Carcinome épidermoïde Primitif de la Prostate: A propos d’un cas et revue de la littérature. AFRICAN JOURNAL OF UROLOGY 2016. [DOI: 10.1016/j.afju.2015.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
22
|
|
23
|
Basiri A, Narouie B, Moghadasi MH, Ghasemi-Rad M, Valipour R. Primary Adenocarcinoma of the Urethra: A Case Report and Review of the Literature. J Endourol Case Rep 2015; 1:75-7. [PMID: 27579397 PMCID: PMC4996557 DOI: 10.1089/cren.2015.0026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Primary adenocarcinoma of the urethra is rarely reported. We report a case of a 47-year-old male with symptoms of urinary obstruction started 2 years before diagnosis. Video-assisted urethrocystoscopy revealed a papillary mass almost obstructing the entire lumen with bleeding. Pathology report was consistent with primary adenocarcinoma of the urethra.
Collapse
Affiliation(s)
- Abbas Basiri
- Urology and Nephrology Research Center, Department of Urology and Renal Transplantation, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Behzad Narouie
- Urology and Nephrology Research Center, Department of Urology and Renal Transplantation, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mohammad Hossein Moghadasi
- Department of Medical Laboratory, Shahid Labbafinejad Medical Center, Iranian Social Security Organization Tehran , Iran
| | - Mohammad Ghasemi-Rad
- Division of Interventional Radiology, Harvard Medical School , Massachusetts General Hospital, Boston, Massachusetts
| | - Reza Valipour
- Urology and Nephrology Research Center, Department of Urology and Renal Transplantation, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| |
Collapse
|
24
|
Abstract
Primary squamous cell carcinoma of the prostate is a unique and rare clinicopathological entity with fewer than 100 cases reported in the literature. Because of its rarity, the optimal management is not well known. Here, we report a case of primary squamous cell carcinoma of the prostate which was treated with definitive concurrent chemo-radiotherapy with excellent outcome along with a brief review of the literature. This is a case report about a rare form of prostate cancer called squamous cell cancer. It behaves more aggressively compared with more common types of prostate cancer. The treatment is controversial due to its rarity, but is different than that of the common variety of prostate cancer. From available limited information, it can be treated either with combined chemotherapy and radiotherapy or radical surgery for early stage disease.
Collapse
|
25
|
Al-Qassim Z, Mohammed A, Payne D, Stocks PJ, Khan Z. Squamous cell carcinoma of the prostate following treatment with an LHRH-agonist: a rare case of transformation of adenocarcinoma of the prostate. Cent European J Urol 2014; 67:26-8. [PMID: 24982776 PMCID: PMC4074708 DOI: 10.5173/ceju.2014.01.art5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 01/02/2014] [Accepted: 01/15/2014] [Indexed: 11/22/2022] Open
Abstract
Squamous cell carcinoma (SCC) is a rare variant of prostate cancer. We report a case of a patient who was diagnosed with metastatic adenocarcinoma of the prostate, treated with leuprorelin and subsequently found to have SCC 18 months later. We have found one case in the literature with a similar scenario of possible transformation of adenocarcinoma to SCC secondary to luteinizing hormone-releasing hormone (LHRH) treatment. We found interesting similarities between the two cases, which raise the possibility of the transformation of tumour type and highlights the importance of the clinical picture in the follow-up, even with low prostate specific antigen (PSA) value.
Collapse
Affiliation(s)
- Zubair Al-Qassim
- Urology Department, Kettering General Hospital, Northamptonshire, United Kingdom
| | - Aza Mohammed
- Urology Department, Kettering General Hospital, Northamptonshire, United Kingdom
| | - David Payne
- Urology Department, Kettering General Hospital, Northamptonshire, United Kingdom
| | - Philippa Jane Stocks
- Pathology Department, Kettering General Hospital, Northamptonshire, United Kingdom
| | - Zeb Khan
- Urology Department, Kettering General Hospital, Northamptonshire, United Kingdom
| |
Collapse
|
26
|
Jiang Q, Liu S, Peng J, Xiong H, Xiong Z, Yang Y, Tan X, Gao X. An extraordinary T/NK lymphoma, nasal type, occurring primarily in the prostate gland with unusual CD30 positivity: case report and review of the literature. Diagn Pathol 2013; 8:94. [PMID: 23773344 PMCID: PMC3707818 DOI: 10.1186/1746-1596-8-94] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 05/21/2013] [Indexed: 01/14/2023] Open
Abstract
Extranodal NK/T cell lymphoma(NKTCL), nasal type, occurring primarily in the prostate gland, is extremely rare. We present a case of primarily prostatic NKTCL in a 59-year-old man suffering from dysuria. Histological examinations revealed that diffused, large-sized, pleomorphic lymphocytes were arranged in an angiocentric distribution with large areas of geographic necroses. Additionally, the prostatic glands were diffusely infiltrated by heteromorphous lymphocytes forming lymphoepithelial lesions. The tumor cells were strongly expressed CD3ϵ, CD56, TIA-1, granzyme B and EBV-encoded RNAs. And interestingly, the lymphoid cells were also strongly immunoreactive with CD30. A rearrangement study showed T-cell receptor γ-chain gene rearrangement with monoclonal appearance. Though postoperative combination of chemotherapy was given, the patient died four months later. Our observation and other literatures indicate that extremely rare NKTCLs unusually express CD30. TCR gene rearrangement existed in some NKTCL, suggesting that a subset of NKTCL may be a mixed NK/T-cell differentiation.
Collapse
Affiliation(s)
- QingPing Jiang
- Department of Urology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou 510150, China
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Gakis G, Witjes JA, Compérat E, Cowan NC, De Santis M, Lebret T, Ribal MJ, Sherif AM. EAU guidelines on primary urethral carcinoma. Eur Urol 2013; 64:823-30. [PMID: 23582479 DOI: 10.1016/j.eururo.2013.03.044] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 03/23/2013] [Indexed: 12/15/2022]
Abstract
CONTEXT The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE To review the current literature on the diagnosis and treatment of patients with primary UC and assess its level of scientific evidence. EVIDENCE ACQUISITION A systematic literature search was performed to identify studies reporting urethral malignancies. Medline was searched using the controlled vocabulary of the Medical Subject Headings database, along with a free-text protocol. EVIDENCE SYNTHESIS Primary UC is considered a rare cancer, accounting for <1% of all malignancies. Risk factors for survival include age, tumour stage and grade, nodal stage, presence of distant metastasis, histologic type, tumour size, tumour location, and modality of treatment. Pelvic magnetic resonance imaging is the preferred method to assess the local extent of urethral tumour; computed tomography of the thorax and abdomen should be used to assess distant metastasis. In localised anterior UC, urethra-sparing surgery is an alternative to primary urethrectomy in both sexes, provided negative surgical margins can be achieved. Patients with locally advanced UC should be discussed by a multidisciplinary team of urologists, radiation oncologists, and oncologists. Patients with noninvasive UC or carcinoma in situ of the prostatic urethra and prostatic ducts can be treated with a urethra-sparing approach with transurethral resection and bacillus Calmette-Guérin (BCG). Cystoprostatectomy with extended pelvic lymphadenectomy should be reserved for patients not responding to BCG or as a primary treatment option in patients with extensive ductal or stromal involvement. CONCLUSIONS The 2013 guidelines document on primary UC is the first publication on this topic by the EAU. It aims to increase awareness in the urologic community and provide scientific transparency to improve outcomes of this rare urogenital malignancy.
Collapse
Affiliation(s)
- Georgios Gakis
- Department of Urology, Eberhard-Karls University, Tübingen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Yamazaki H, Ohyama T, Tsuboi T, Taoka Y, Kohguchi D, Iguchi H, Ao T. Prostatic stromal sarcoma with neuroectodermal differentiation. Diagn Pathol 2012; 7:173. [PMID: 23217062 PMCID: PMC3542249 DOI: 10.1186/1746-1596-7-173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/14/2012] [Indexed: 12/11/2022] Open
Abstract
Abstract Prostatic stromal sarcoma is a fairly rare tumor that constitutes approximately 0.1–0.2% of all prostatic cancers. Detailed characteristics of the tumor are still unclear due to its rarity. We describe a case of prostatic stromal sarcoma in a 63 year-old man who suffered from urinary obstructive symptoms. Palliative transuterine resection was performed and the preliminary histopathological diagnosis was neuroendocrine carcinoma. After chemotherapy, total pelvic exenteration was performed. Histopathologically, the tumor was composed of monotonously proliferating small to medium-sized round cells, which existed in compact islands with loose or dense fibrovascular networks. Immunohistochemically, the tumor cells were widely positive for vimentin, CD56, CD99 and focally positive for synaptophysin, CD10, progesterone receptor, desmin and CD34, but negative for EMA, cytokeratin, estrogen receptor, S-100 and myoglobin. Most of the previously reported tumors exhibited positive stainability for CD10 and progesterone receptor. In addition to these markers, expressions of CD56, CD99 and synaptophysin were characteristically detected in our case. To the best of our knowledge, we present the first case of prostatic stromal sarcoma with characteristic immunohistochemical staining properties. Although the biological characteristics of this rare tumor have not yet been elucidated, these findings suggest prostatic stromal sarcoma can potentially show neuroectodermal differentiation. Virtual slide The virtual slide(s) for this article can be found here:
http://www.diagnosticpathology.diagnomx.eu/vs/7291874028051262
Collapse
Affiliation(s)
- Hitoshi Yamazaki
- Department of Pathology, Medical center hospital, Kitasato Institute, Kitasato University, Saitama, Japan.
| | | | | | | | | | | | | |
Collapse
|
29
|
|