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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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Shalata W, Abu Jama A, Abu Salman A, Golosky M, Solomon A, Abu Saleh O, Michlin R, Shalata S, Agbarya A, Yakobson A. Unexpected and Rare Sites of Metastasis in Oncologic Patients. J Clin Med 2023; 12:6447. [PMID: 37892585 PMCID: PMC10607747 DOI: 10.3390/jcm12206447] [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: 08/25/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Case studies of rare oncologic metastases are an important source of clinical data for health care professionals and researchers. While infrequent, the knowledge base and clinical recommendations derived from such cases aid in advancements in the field. As such, we aim to add five cases to the growing body of literature. The first two male patients, aged 69 and 73, were diagnosed with colon adenocarcinoma, suspected to be a second primary prostate carcinoma, following positron emission tomography-computer tomography (PET-CT). This suspicion was ruled out by prostatectomy and histopathological investigations, which instead found adenocarcinoma of colonic origin. The next two male patients, ages 63 and 68, were diagnosed, respectively, with metastatic pancreatic adenocarcinoma with cardiac metastases and metastatic melanoma with distant metastases to the pancreas. The final patient was a 73-year-old male diagnosed with metastatic breast cancer after a radiological investigation of suspected renal cell carcinoma.
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Affiliation(s)
- Walid Shalata
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Ashraf Abu Jama
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Amjad Abu Salman
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Cardiology Division, Soroka Medical Center, Beer Sheva 84105, Israel
| | - Mitchell Golosky
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Adam Solomon
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Omar Abu Saleh
- Department of Dermatology and Venereology, The Emek Medical Centre, Afula 18341, Israel
| | - Regina Michlin
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
| | - Sondos Shalata
- Nutrition Unit, Galilee Medical Center, Nahariya 22000, Israel;
| | - Abed Agbarya
- Department of Oncology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Alexander Yakobson
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
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Hernández Alonso R, Soto Sánchez A, Lara Castro A, Hernández Barroso M, Pérez Sánchez E, Díaz Jiménez N, Hernández Hernández G, Barrera Gómez MÁ. Prostate gland metastasis as a late relapse of rectal adenocarcinoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:97-98. [PMID: 35748476 DOI: 10.17235/reed.2022.8940/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present a case report of a 49 year old patient with a known history of rectal adenocarcinoma treated with extended abdominal perineal resection. After five the patient was diagnosed with metastases to the prostate gland. This case stands out not only due to the infrequency of an onset of a colorectal tumor in the prostatic gland but also the late onset of the tumor. In these cases the differential diagnosis between a metastatic tumor and a primary urologic tumor is difficult due to similar morphology and histology, making the CDX-2 immunohistochemical maker expression an important tool to define the histopathology of the tumor.
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Affiliation(s)
- Ricardo Hernández Alonso
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria, España
| | - Ana Soto Sánchez
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria, España
| | | | - Moisés Hernández Barroso
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria
| | - Eduardo Pérez Sánchez
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria
| | - Nélida Díaz Jiménez
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria, España
| | | | - Manuel Ángel Barrera Gómez
- Cirugía General y del Aparato Digestivo, Hospital General Universitario Nuestra Señora de la Candelaria, España
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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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Metastatic Breast Carcinoma to the Prostate Gland. Case Rep Oncol Med 2016; 2016:8264140. [PMID: 27429817 PMCID: PMC4939205 DOI: 10.1155/2016/8264140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/12/2016] [Indexed: 11/28/2022] Open
Abstract
Cancer of the male breast is an uncommon event with metastases to the breast occurring even less frequently. Prostate carcinoma has been reported as the most frequent primary to metastasize to the breast; however, the reverse has not been previously reported. Herein, we present, for the first time, a case of breast carcinoma metastasizing to the prostate gland. Prostate needle core biopsy revealed infiltrative nests of neoplastic epithelioid cells, demonstrated by immunohistochemistry (IHC) to be positive for GATA3 and ER and negative for PSA and P501S. A prostate cocktail by IHC study demonstrated lack of basal cells (p63 and CK903) and no expression of P501S. The patient's previous breast needle core biopsy showed strong ER positivity and negative staining for PR and HER2. Similar to the prostate, the breast was negative for CK5/6, p63, and p40. This case demonstrates the importance of considering a broad differential diagnosis and comparing histology and IHC to prior known malignancies in the setting of atypical presentation or rare tumors.
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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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