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Giannakodimos I, Ziogou A, Giannakodimos A, Mitakidi E, Tzelepis K, Fragkiadis E, Charalampakis N. Primary Paraganglioma of the Prostate: A Systematic Review of the Literature for A Rare Entity. Rev Recent Clin Trials 2024; 19:189-195. [PMID: 38549519 DOI: 10.2174/0115748871293735240209052044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Paragangliomas of the urinary tract are exceptionally uncommon, and sporadic case reports of primary paraganglioma of the prostate have been reported in the literature. METHODS Systematic research in PubMed/Medline and Scopus databases concerning primary prostatic paraganglioma was performed by two independent investigators. RESULTS This analysis included 25 adult males, with a mean age of 49.8 ± 22.4 years. 32% of included patients had a history of hypertension. Problems during urination (52%), blood loss (44%), either as hematuria or hemospermia, and catecholamine-related symptoms (36%) comprised the most frequently reported clinical manifestations. Digital rectal examination found a palpable nodule in 36% of patients, while prostatic specific antigen (PSA) was normal in all tested patients. Abdominal ultrasound (44%), computed tomography (44%) and magnetic resonance imaging (28%) helped to identify the primary lesion. 24-hour urine epinephrine, norepinephrine and vanillylmandelic acid (VMA) levels were elevated in 90%, 80% and 90% of included patients. Open surgical excision of the mass was performed in 40%, transurethral resection in 8%, open radical prostatectomy in 24%, transurethral resection of the prostate in 16% and robot-assisted radical prostatectomy in 4% of included patients. CONCLUSION Due to atypical clinical manifestation and scarcity of prostatic paraganglioma, urologists should be aware of this extremely rare entity.
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Affiliation(s)
- Ilias Giannakodimos
- Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Afroditi Ziogou
- Department of Medical Oncology, Metaxa Cancer Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexios Giannakodimos
- Department of Medical Oncology, Metaxa Cancer Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Mitakidi
- Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tzelepis
- Department of Urology, Geniko Kratiko Nikaias General Hospital, Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Fragkiadis
- Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Charalampakis
- Department of Medical Oncology, Metaxa Cancer Hospital, National and Kapodistrian University of Athens, Athens, Greece
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2
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Dondi F, Antonelli A, Suardi N, Guerini AE, Albano D, Lucchini S, Camoni L, Treglia G, Bertagna F. PET/CT and Conventional Imaging for the Assessment of Neuroendocrine Prostate Cancer: A Systematic Review. Cancers (Basel) 2023; 15:4404. [PMID: 37686680 PMCID: PMC10486674 DOI: 10.3390/cancers15174404] [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: 07/04/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Neuroendocrine prostate cancer (NEPC) is a rare neoplasm, and the role of both conventional imaging (CI) and positron emission tomography/computed tomography (PET/CT) for its assessment has not been clearly evaluated and demonstrated. The aim of this systematic review was to analyze the diagnostic performances of these imaging modalities in this setting. METHODS A wide literature search of the PubMed/MEDLINE, Scopus, and Web of Science databases was made to find relevant published articles about the role of CI and PET/CT for the evaluation of NEPC. RESULTS 13 studies were included in the systematic review. PET/CT imaging with different radiopharmaceuticals has been evaluated in many studies (10) compared to CI (3 studies), which has only a limited role in NEPC. Focusing on PET/CT, a study used [18F]FDG, labeled somatostatin analogs were used in 5 cases, a study used [68Ga]Ga-FAPI-04, [68Ga]Ga-PSMA-11 was evaluated in a single case, and two works used different tracers. CONCLUSION Published data on the role of PET/CT for the assessment of NEPC are limited. At present, it is still uncertain which tracer performs best, and although [18F]FDG has been evaluated and seems to offer some advantages in availability and clinical staging, other tracers may be more useful to understand tumor biology or identify targets for subsequent radioligand therapy. Further research is therefore desirable. In contrast, data are still limited to draw a final conclusion on the role and the specific characteristics of CI in this rare form of neoplasm, and therefore, more studies are needed in this setting.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | | | - Nazareno Suardi
- Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Andrea Emanuele Guerini
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Domenico Albano
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Silvia Lucchini
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Luca Camoni
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Giorgio Treglia
- Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Francesco Bertagna
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
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3
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Sharbidre KG, Morani AC, Zahid M, Bhosale P, Lall C, Francis IR, Verma S. Imaging of neuroendocrine neoplasms of the male GU tract. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:4042-4057. [PMID: 35412112 DOI: 10.1007/s00261-022-03510-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 01/18/2023]
Abstract
Male genitourinary neuroendocrine neoplasms (GU-NENs) are rare, without any definite imaging characteristics. The WHO classified neuroendocrine neoplasms in the 2016 classification of the tumors of the urinary tract and genital organs along with other GU tumors; however, no pathologic grading system is available as published for gastroenteropancreatic neuroendocrine neoplasms. Often a multimodality approach using cross-sectional imaging techniques, such as molecular imaging and histopathology are implemented to arrive at the diagnosis. This article provides a review of the pathology and imaging features of the male GU-NENs.
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Affiliation(s)
- Kedar G Sharbidre
- Department of Radiology, University Of Alabama at Birmingham, Birmingham, USA.
| | - Ajaykumar C Morani
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Mohd Zahid
- Department of Radiology, University Of Alabama at Birmingham, Birmingham, USA
| | - Priya Bhosale
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Chandana Lall
- Department of Radiology, University of Florida, Gainesville, USA
| | | | - Sadhna Verma
- Department of Radiology, University of Cincinnati, Cincinnati, USA
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4
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Marcal LP, Surabhi VR, Ramani NS, Katabathina VS, Paspulati RM, Prasad SR. Mesenchymal Neoplasms of the Prostate and Seminal Vesicles: Spectrum of Disease with Radiologic-Pathologic Correlation. Radiographics 2022; 42:417-432. [PMID: 35030067 DOI: 10.1148/rg.210084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is a wide spectrum of benign and malignant mesenchymal neoplasms of the prostate, which account for less than 1% of all prostatic tumors. These include distinctive tumors that arise from the specialized prostatic stroma and site-agnostic neoplasms such as smooth muscle tumors, fibrous or myofibroblastic neoplasms, neurogenic tumors, vascular tumors, and a plethora of sarcomas. Select tumors show classic sites of origin within the prostate. While stromal tumors of uncertain malignant potential (STUMPs) commonly involve the peripheral zone at the prostate base, leiomyomas typically originate from the central prostate toward the apex. Some "prostatic" neoplasms such as gastrointestinal stromal tumors, solitary fibrous tumor (SFT), paragangliomas, and neurogenic tumors arise primarily from periprostatic soft tissues. Most mesenchymal tumors of the prostate and seminal vesicles manifest as large tumors that cause nonspecific symptoms; prostate-specific antigen level is not typically elevated. Diverse mesenchymal neoplasms demonstrate characteristic histopathologic and immunocytochemical features and variable cross-sectional imaging findings. While leiomyoma and SFT typically display low signal intensity on T2-weighted images, synovial sarcomas commonly show hemorrhage. Diagnosis is difficult because of the rarity and lack of awareness of the tumors and the significant overlap in histopathologic features. Select tumors show characteristic genetic abnormalities that allow the diagnosis to be established. For example, more than 90% of SFTs are characterized by a unique NAB2-STAT6 gene fusion, and more than 95% of synovial sarcomas are associated with a distinctive SYT-SSX chimeric transcript. Accurate diagnosis is imperative for optimal management owing to markedly different tumor biology as well as attendant therapeutic and prognostic implications. While STUMPs commonly recur, sarcomas typically charter an aggressive course with poor prognosis. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Leonardo P Marcal
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
| | - Venkateswar R Surabhi
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
| | - Nisha S Ramani
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
| | - Venkata S Katabathina
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
| | - Raj M Paspulati
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
| | - Srinivasa R Prasad
- From the Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030-4009 (L.P.M., V.R.S., S.R.P.); Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, Tex (N.S.R.); Department of Radiology, University of Texas Health Science Center, San Antonio, Tex (V.S.K.); and Department of Radiology, Case Western Reserve University, Cleveland, Ohio (R.M.P.)
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5
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Ehsanullah S, Rashid SZ, Haq A, Ehsanullah SAA. A Rare Case of Synovial Sarcoma of the Prostate Causing Urinary Retention. Cureus 2022; 14:e21057. [PMID: 35155022 PMCID: PMC8825446 DOI: 10.7759/cureus.21057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 11/05/2022] Open
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6
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Kanas AF, Fenelon SS, Santos JMMM, Coelho RF, Guglielmetti GB, Nahas WC, Viana PCC. Case 297: Mucinous Adenocarcinoma of the Prostate. Radiology 2021; 302:238-242. [PMID: 34928731 DOI: 10.1148/radiol.202949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 70-year-old man was referred to our institution with chronic obstructive urinary symptoms and constipation for 2 years before admission. His medical history was unremarkable. Outside laboratory tests revealed an elevated serum prostate-specific antigen level (21.7 ng/mL [normal range, 0.00-4.00 ng/mL]), and urinalysis results were negative. He was admitted for evaluation of possible prostate cancer. The patient reported no specific symptoms of infection and denied fever, dysuria, hematuria, and abdominal pain. He had no family history of prostate cancer. On physical examination, he was afebrile, and the digital rectal examination was not painful. These findings were evidence of an enlarged prostate and a hard multilobulated mass, which was palpable bilaterally. The urologic team performed MRI of the prostate.
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Affiliation(s)
- Alexandre Fligelman Kanas
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - Sandro Santos Fenelon
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - João Manoel Miranda Magalhães Santos
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - Rafael Ferreira Coelho
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - Giuliano Betoni Guglielmetti
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - William Carlos Nahas
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
| | - Publio Cesar Cavalcante Viana
- From the Department of Radiology and Oncology, Divisions of Interventional Radiology (A.F.K., P.C.C.V.) and Diagnostic Radiology (S.S.F., J.M.M.M.S., P.C.C.V.), and Department of Surgery, Division of Urology (R.F.C., G.B.G., W.C.N.), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, Cerqueira César, São Paulo, SP 05403-000
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Han C, Zhu L, Liu X, Ma S, Liu Y, Wang X. Differential diagnosis of uncommon prostate diseases: combining mpMRI and clinical information. Insights Imaging 2021; 12:79. [PMID: 34132898 PMCID: PMC8208342 DOI: 10.1186/s13244-021-01024-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/31/2021] [Indexed: 01/03/2023] Open
Abstract
The differential diagnosis of abnormalities in the prostate is broad, covering common (acinar adenocarcinoma, benign prostatic hyperplasia, chronic prostatitis, hemorrhage, cysts, calcifications, atrophy and fibrosis) and less common conditions (tumors other than acinar adenocarcinoma, granulomatous prostatitis containing tuberculosis, abscesses and other conditions, and idiopathic disorders such as amyloidosis and exophytic benign prostatic hyperplasia). Recent advances in magnetic resonance imaging (MRI) of the prostate gland and imaging guidelines, such as the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1), have dramatically improved the ability to distinguish common abnormalities, especially the ability to detect clinically significant prostate cancer (csPCa). Overlap can exist in the clinical history and imaging features associated with various common/uncommon prostate abnormalities, and biopsy is often required but is invasive. Prostate abnormalities can be divided into two categories: category 1, diseases for which PI-RADS scores are suitable for use, and category 2, diseases for which PI-RADS scores are unsuitable for use. Radiologists must have an intimate knowledge of other diseases, especially uncommon conditions. Past relevant history, symptoms, age, serum prostate-specific antigen (PSA) levels, MRI manifestations, and the applicability of the PI-RADS assessment should be considered when diagnosing prostate abnormalities.
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Affiliation(s)
- Chao Han
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Lina Zhu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, ZhengzhouHenan Province, 450052, China
| | - Xiang Liu
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Shuai Ma
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yi Liu
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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8
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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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9
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Suzuki I, Kijima T, Owada A, Kamai T. Case of prostate stromal tumour of uncertain malignant potential where positron emission tomography with 18F-fluorodeoxyglucose was useful for surgical planning. BMJ Case Rep 2020; 13:13/9/e235738. [PMID: 32913066 DOI: 10.1136/bcr-2020-235738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Stromal tumour of uncertain malignant potential of the prostate is a rare tumour with a variable clinical behaviour ranging from incidentally detected indolent tumours that never progress, to aggressive diseases almost identical to sarcomas that may invade surrounding organs or develop metastases. Surgical excision is generally recommended for local diseases; however, owing to its diverse clinical outcomes, optimal management may vary from surgery alone to wide excision combined with chemotherapy and/or radiotherapy. Therefore, preoperative evaluation of the malignant potential of the disease is essential to decide the treatment strategy. Herein, we report a case of stromal tumour of uncertain malignant potential successfully treated with minimally invasive robot-assisted radical prostatectomy alone under the diagnosis of the disease with low malignant potential based on the findings of positron emission tomography with 18F-fluorodeoxyglucose.
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Affiliation(s)
- Issei Suzuki
- Urology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
| | - Toshiki Kijima
- Urology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
| | - Atsuko Owada
- Diagnostic Pathology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
| | - Takao Kamai
- Urology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
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10
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Portugal Teixeira I, Pereira PR, Silva A, Castro M. Giant multilocular prostatic cystadenoma, a diagnosis to consider in large pelvic male masses. Radiol Case Rep 2019; 14:1473-1477. [PMID: 31641395 PMCID: PMC6796614 DOI: 10.1016/j.radcr.2019.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 11/01/2022] Open
Abstract
Giant multilocular prostatic cystadenomas are rare benign prostatic tumor, usually presenting as a large pelvic mass, compressing the adjacent organs but with no clear aggressive features, frequently causing obstructive voiding symptoms. Nowadays, imaging plays an important role on the adequate characterization of these lesions, not only on depicting their different internal components, but also the relationship with the adjacent structures, therefore providing the best preoperative surgical planning. Here we present a case of a 62-year-old patient with recurrent obstructive voiding symptoms due to a giant multilocular prostatic cystadenomas, with histologically correlation, posteriorly excised.
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Affiliation(s)
- Inês Portugal Teixeira
- Department of Radiology, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Pedro Rodrigues Pereira
- Department of Pathology, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Anabela Silva
- Department of Radiology, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Miguel Castro
- Department of Radiology, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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11
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Karaosmanoglu AD, Uysal A, Onur MR, Hahn PF, Ayhan AS, Ozmen MN, Akata D, Karcaaltincaba M. Primary lymphomas of the intraabdominal solid organs and the gastrointestinal tract: spectrum of imaging findings with histopathological confirmation. Abdom Radiol (NY) 2019; 44:2988-3005. [PMID: 31209544 DOI: 10.1007/s00261-019-02100-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Unlike nodal lymphoma, primary lymphomas of the intraabdominal organs are uncommon neoplasms whose diagnosis may be challenging in certain clinical circumstances. Despite this difficulty for imaging diagnosis, there are several imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography that may suggest the correct diagnosis. The scope of this review is to describe and illustrate the imaging features of primary lymphoma of intraabdominal organs providing clues to the diagnosis, together with their pathological correlations.
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12
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Feng ZY, Min XD, Wang L, Li BS, Ke Z, Zhang PP, Kang Z. MRI feature analysis of uncommon prostatic malignant tumors. Asian J Androl 2019; 20:313-315. [PMID: 28566559 PMCID: PMC5952491 DOI: 10.4103/aja.aja_12_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Zhao-Yan Feng
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiang-De Min
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liang Wang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ba-Sen Li
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zan Ke
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Pei-Pei Zhang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Kang
- The Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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13
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Katabathina VS, Vikram R, Olaoya A, Paspulati RM, Nicolas MM, Rao P, Zaheer A, Prasad SR. Neuroendocrine neoplasms of the genitourinary tract in adults: cross-sectional imaging spectrum. Abdom Radiol (NY) 2017; 42:1472-1484. [PMID: 27942847 DOI: 10.1007/s00261-016-1012-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Neuroendocrine (NE) neoplasms of the genitourinary (GU) tract in adults are rare tumors with distinct histopathology and variable biological behavior and imaging findings. They may be primary or metastatic in origin. The spectrum of primary GU tract NE neoplasms includes carcinoid, small cell carcinoma, large cell NE carcinoma, and paraganglioma. The tumors commonly show positivity to specific immunohistochemical markers and characteristic dense-core granules at the ultra-structural level. Although imaging findings are nonspecific and accurate differentiation from the more common malignancies of the individual organs is not possible, cross-sectional imaging modalities play an important role in the diagnosis, staging, and surveillance of these tumors. Somatostatin receptor scintigraphy (octreotide scan) may be useful in the detection and treatment of metastatic disease in select patients. Knowledge of the various NE tumors of the adult GU tract and familiarity with their pathological and imaging findings permit optimal patient management.
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14
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Rohena-Quinquilla IR, Lattin GE, Wolfman D. Imaging of Extranodal Genitourinary Lymphoma. Radiol Clin North Am 2017; 54:747-64. [PMID: 27265606 DOI: 10.1016/j.rcl.2016.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The genitourinary (GU) system is commonly affected by disseminated lymphoma. Rarely, lymphoma can originate from and remain localized to one of the GU organs and thus presents as primary extranodal disease. Up to 40% of lymphomas present as extranodal disease, with only 3% having the GU system as the primary site of involvement. This article describes and correlates the radiologic and pathologic features of extranodal lymphomatous disease affecting the GU system with specific focus on the kidneys, adrenal glands, testicles, and ovaries. Lymphoma of the uterine body and cervix, external female genitalia, urinary bladder, and prostate gland is briefly discussed.
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Affiliation(s)
- Iván R Rohena-Quinquilla
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Department of Radiology, Martin Army Community Hospital, 6600 Van Aalst Boulevard, Fort Benning, GA 31905-5637, USA
| | - Grant E Lattin
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; American Institute for Radiologic Pathology, 1010 Wayne Avenue, Suite 320, Silver Spring, MD 20910, USA
| | - Darcy Wolfman
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; American Institute for Radiologic Pathology, 1010 Wayne Avenue, Suite 320, Silver Spring, MD 20910, USA; Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814, USA.
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15
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Maleki S, Cajigas A, Moss J, Ramesh KH, Khader S. Fine-needle aspiration biopsy of prostate synovial sarcoma: A case report and review of the literature. Diagn Cytopathol 2016; 45:168-172. [DOI: 10.1002/dc.23623] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/19/2016] [Accepted: 09/28/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Sara Maleki
- Department of Pathology; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; New York
| | - Antonio Cajigas
- Department of Pathology; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; New York
| | - Jason Moss
- Department of Pathology; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; New York
| | | | - Samer Khader
- Department of Pathology; Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; New York
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Li Y, Mongan J, Behr SC, Sud S, Coakley FV, Simko J, Westphalen AC. Beyond Prostate Adenocarcinoma: Expanding the Differential Diagnosis in Prostate Pathologic Conditions. Radiographics 2016; 36:1055-75. [PMID: 27315446 DOI: 10.1148/rg.2016150226] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Recent advances in magnetic resonance (MR) imaging of the prostate gland have dramatically improved the ability to detect and stage adenocarcinoma of the prostate, one of the most frequently diagnosed cancers in men and one of the most frequently diagnosed pathologic conditions of the prostate gland. A wide variety of nonadenocarcinoma diseases can also be seen with MR imaging, ranging from benign to malignant diseases, as well as infectious and inflammatory manifestations. Many of these diseases have distinctive imaging features that allow differentiation from prostate acinar adenocarcinoma. Early recognition of these entities produces a more accurate differential diagnosis and may enable more expeditious clinical workup. Benign neoplasms of the prostate include plexiform neurofibroma and cystadenoma, both of which demonstrate distinctive imaging features. Stromal neoplasms of uncertain malignant potential are rare tumors of uncertain malignant potential that are often difficult to distinguish at imaging from more-malignant prostate sarcomas. Other malignant neoplasms of the prostate include urothelial carcinoma, primary prostatic carcinoid, carcinosarcoma, endometrioid or ductal adenocarcinoma, and mucinous adenocarcinoma. Prostatic infections can lead to abscesses of pyogenic, tuberculous, or fungal origins. Finally, miscellaneous idiopathic disorders of the prostate include amyloidosis, exophytic benign prostatic hyperplasia, and various congenital cysts. Considerable overlap can exist in the clinical history and imaging findings associated with these prostate pathologic conditions, and biopsy is often required for ultimate confirmation of the diagnosis. However, many diagnoses, including cystadenoma, mucinous adenocarcinoma, sarcoma, and abscesses, have distinct imaging features, which can enable the informed radiologist to identify the diagnosis and recommend appropriate clinical workup and management. (©)RSNA, 2016.
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Affiliation(s)
- Yi Li
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - John Mongan
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - Spencer C Behr
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - Seema Sud
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - Fergus V Coakley
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - Jeffry Simko
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
| | - Antonio C Westphalen
- From the Department of Radiology and Biomedical Imaging (Y.L., J.M., S.C.B., A.C.W.) and Department of Pathology (J.S.), University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628; Department of Radiology, Sir Ganga Ram Hospital, New Delhi, India (S.S.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (F.V.C.)
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Raj DH, Dash PK, Mohanty J, Sarangi PK. Leiomyosarcoma of the prostate-an unexpected histopathological outcome. BMJ Case Rep 2016; 2016:bcr-2016-215594. [PMID: 27284101 DOI: 10.1136/bcr-2016-215594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for >0.1% of all primary prostate malignancies. We report a case of a patient, presenting with recurrent episodes of dysuria, who had been diagnosed and operated for benign prostatic hyperplasia 1 month earlier, and now presented with similar symptoms postoperatively. Trans-rectal biopsy of the prostate was carried out and histopathology revealed leiomyosarcoma of the prostate.
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Affiliation(s)
- Dinesh Harvey Raj
- Department of Radiodiagnosis, SCB Medical College, Cuttack, Odisha, India
| | - Prafulla Kumar Dash
- Department of Radiodiagnosis, CMIIL-SCB Medical MRI Centre, Cuttack, Odisha, India
| | - Jayashree Mohanty
- Department of Radiodiagnosis, SCB Medical College, Cuttack, Odisha, India
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18
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Berniker AV, Abdulrahman AA, Teytelboym OM, Galindo LM, Mackey JE. Extrapulmonary small cell carcinoma: imaging features with radiologic-pathologic correlation. Radiographics 2015; 35:152-63. [PMID: 25590395 DOI: 10.1148/rg.351140050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Extrapulmonary small cell carcinoma (EPSCC) refers to small cell carcinoma arising outside of the lungs. EPSCC extrapulmonary small cell carcinoma is a rare aggressive neoplasm, representing a minority of all small cell carcinomas. Despite its uncommon occurrence, EPSCC extrapulmonary small cell carcinoma has been described in nearly every organ, most commonly in the gastrointestinal and genitourinary systems. As such, it is important for radiologists to be aware of the entity. Although imaging is neither sensitive nor specific for EPSCC extrapulmonary small cell carcinoma , it plays an important role by helping exclude metastases from a primary pulmonary tumor, establish tumor staging, and assess response to therapy. EPSCC extrapulmonary small cell carcinoma is diagnosed by demonstrating pathologic features of small cell carcinoma in an extrapulmonary site. There are two ways to stage EPSCC extrapulmonary small cell carcinoma . One method uses the Veterans Administration Lung Study Group system developed for small cell lung cancer that allocates patients into limited or extensive disease categories. The second approach is the American Joint Committee on Cancer tumor-node-metastasis system applied to other tumor subtypes arising from the same organ. Because of its rare and varied manifestations, the most effective treatment for EPSCC extrapulmonary small cell carcinoma has not been established. Current management recommendations are derived from retrospective studies and single-institution experiences or are extrapolated from small cell lung cancer data. Regardless of therapy, overall survival rates are poor, with 5-year survival rates around 13%. To help radiologists increase their familiarity with EPSCC extrapulmonary small cell carcinoma , this article provides (a) a background for EPSCC extrapulmonary small cell carcinoma based on the literature and (b) a pictorial review of EPSCC extrapulmonary small cell carcinoma in multiple organs, with radiologic-pathologic correlation.
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Affiliation(s)
- Abigail V Berniker
- From the Departments of Radiology (A.V.B., O.M.T., J.E.M.) and Pathology (A.A.A., L.M.G.), Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023
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19
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Szarszewski A, Gulczyński J. The history of calculus mendax and the following surgery on the prostate. Prostate 2014; 74:1465-70. [PMID: 25154615 DOI: 10.1002/pros.22864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/01/2014] [Indexed: 11/08/2022]
Abstract
In this paper we would like to present probably the first surgery performed on the prostate gland followed by microscopic analysis of the obtained tumor tissue sample. We based on the existing correspondence between Ludwig von Hammen and Johann N. Pechlin, and their successors in this field as well. Von Hammen seems to be a pioneer in the area of not only urological surgery but in directing this part of medical practice from "lithotomists" to physicians, much better educated than barbers in physiology but first of all in anatomy. This 17th century physician from Gdansk tried to set new standards both for surgical medical practice but histopathological examination of the excised material as well. Due to the change of the operational skills and procedures von Hammen's work got almost forgotten, but remains remembered due to the work of historians of the medicine from following centuries.
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Affiliation(s)
- Adam Szarszewski
- Department of History and Philosophy of Medical Sciences, Medical University of Gdańsk, Gdańsk, Poland
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20
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21
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Altay C, Seçil M, Demir Ö, Tuna B, Yörükoğlu K. Imaging Findings of Prostate Carcinosarcoma: A Case Report. Clin Genitourin Cancer 2014; 12:e139-41. [DOI: 10.1016/j.clgc.2014.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 02/02/2014] [Indexed: 11/30/2022]
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Abstract
PURPOSE The aim of this study was to evaluate F-FDG PET/CT findings of malignant nonepithelial prostate tumors and their correlation with MRI and CT images. PATIENTS AND METHODS FDG PET/CT findings were reviewed in 12 patients with malignant nonepithelial prostate tumor confirmed by pathology. The location, size, SUVmax, pathologic findings, and available MRI and CT images of the tumors were reviewed. RESULTS Of the 12 patients (mean age, 41 years; age range, 19-66 years), 9 had normal prostate-specific antigen levels. The mean size of the tumors was 7.1 cm in diameter ranging from 4.6 to 10.5 cm. All the tumors showed increased metabolic activity with mean SUVmax of 17.5 ranging from 3.6 to 46.8. The high-grade malignant tumors tended to show higher FDG uptake, whereas the intermediate-grade and low-grade malignant ones tended to show lower FDG uptake. Seven tumors had local invasion or distant metastases. Lung was the most common metastatic site. On MRI, the tumors showed well-circumscribed or ill-circumscribed margins with inhomogeneous enhancement. On CT, the tumors showed hypodensity with slight to moderate enhancement. CONCLUSIONS The malignant nonepithelial prostate tumors tended to have large sizes at presentation, have high FDG uptake, and affect a younger population with normal prostate-specific antigen levels. FDG PET/CT may be useful for the assessment of tumor grade and for detecting the distant metastases, whereas the MRI or enhanced CT may be more helpful for describing the relationship between the tumor and adjacent structures.
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23
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Zhang Q, Wang H, Ren L, Qi X, Liu F, Zhang D. Primary synovial sarcoma of the prostate metastatic to the liver and lung: a case report. World J Surg Oncol 2014; 12:194. [PMID: 24969223 PMCID: PMC4086276 DOI: 10.1186/1477-7819-12-194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 06/12/2014] [Indexed: 12/20/2022] Open
Abstract
Primary synovial sarcoma of the prostate is an uncommon malignant tumor. There are few cases reported in the English medical literature to date. Here, we present a case of 22-year-old man with primary synovial sarcoma of the prostate metastatic to the liver and lung. To our knowledge, only six reports of synovial sarcoma involving the prostate have been previously published. We also reviewed the previous treatments and prognoses in previous case reports and evaluate the proper treatment for this disease.
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Affiliation(s)
| | | | | | | | | | - Dahong Zhang
- Department of Urology, Zhejiang Provincial People's Hospital, Hangzhou, China.
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24
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Dong A, Bai Y, Wang Y, Zuo C, Lu J. Spectrum of the prostate lesions with increased FDG uptake on 18F-FDG PET/CT. ACTA ACUST UNITED AC 2014; 39:908-21. [DOI: 10.1007/s00261-014-0114-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Abstract
Primary basal cell carcinoma of the prostate is a very rare neoplasm with a good prognosis. A 55-year-old man presented with urinary frequency for 2 months. Serum prostate-specific antigen level was normal. T2-weighted MR images showed an inhomogeneously hyperintense tumor in the prostate. Enhanced CT showed heterogeneous enhancement of the tumor. FDG PET/CT showed strong FDG uptake of the tumor with SUVmax of 14.1. Prostate biopsy findings revealed basal cell carcinoma with high proliferation index.
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26
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Prostatic stromal neoplasms: differential diagnosis of cystic and solid prostatic and periprostatic masses. AJR Am J Roentgenol 2013; 200:W571-80. [PMID: 23701087 DOI: 10.2214/ajr.12.9741] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objectives of this article are to illustrate the radiologic-pathologic correlation of prostate stromal neoplasms and to review the imaging appearances of cystic and solid prostatic and periprostatic masses that may mimic prostatic stromal neoplasms. CONCLUSION The differential diagnosis for cystic and solid masses in the prostate is broad, and masses arising from periprostatic structures may mimic the appearance of primary prostatic diseases. Attention to clinical and imaging features is helpful in narrowing the differential diagnosis.
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27
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Joyce EA, Kavanagh J, Sheehy N, Beddy P, O'Keeffe SA. Imaging features of extrapulmonary small cell carcinoma. Clin Radiol 2013; 68:953-61. [PMID: 23790688 DOI: 10.1016/j.crad.2013.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 03/30/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
Small cell carcinoma accounts for approximately 20% of lung cancers; however, it rarely occurs at other sites. Extrapulmonary small cell carcinoma (EPSCC) is notoriously aggressive with a strong propensity for both regional and distant spread. The majority of the literature on these uncommon tumours is from a clinicopathological viewpoint with a relative paucity of detail regarding the radiological findings. This review will focus on the imaging features of EPSCC in its predominant sites of origin: the gastrointestinal tract, genitourinary tract, head, neck, and breast. We will also discuss the role of positron-emission tomography (PET)/computed tomography (CT) in the staging of EPSCC.
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Affiliation(s)
- E A Joyce
- Department of Radiology, St James's Hospital and Trinity College Dublin, Dublin, Ireland.
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28
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Andreou A, Whitten C, MacVicar D, Fisher C, Sohaib A. Imaging appearance of sarcomas of the prostate. Cancer Imaging 2013; 13:228-37. [PMID: 23722584 PMCID: PMC3667567 DOI: 10.1102/1470-7330.2013.0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Sarcomas of the prostate are rare tumours. Their clinicopathologic features are well described, however, the imaging features of these tumours have rarely been documented. The purpose of this article is to illustrate the imaging findings of prostate sarcomas, with an emphasis on their appearance on magnetic resonance imaging and to identify features that may help to differentiate them from the commoner prostate adenocarcinomas.
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Affiliation(s)
- Adrian Andreou
- Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UK.
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29
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Latz S, Ellinger J, Goltz D, Marx C, Leuschner I, Müller SC, Fechner G. Spindle cell rhabdomyosarcoma of the prostate. Int J Urol 2013; 20:935-7. [PMID: 23320845 DOI: 10.1111/iju.12082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 12/16/2012] [Indexed: 12/01/2022]
Abstract
The spindle cell rhabdomyosarcoma is a rare variant of the embryonal rhabdomyosarcoma, mostly occurring in childhood. Only a few cases are described in adults. To date, no case of the spindle cell subtype of the prostatic embryonal rhabdomyosarcoma has been published. We report on a 23-year-old man, initially presenting with obstructive micturition problems, perineal pain and night sweat. After diagnosis by transrectal biopsy of the prostate, radiochemotherapy within the CWS 2002 P study was applied: nine cycles of vincristine, doxorubicin, actinomycin D, ifosfamide, and fractionated radiotherapy of the tumor and suspect lymph nodes (final dose 50.4 Gy). The tumor initially shrank, but an early local recurrence arose. Second-line chemotherapy was applied, followed by a salvage radical cytoprostatectomy. The patient died of disseminated disease 14 months after diagnosis.
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Affiliation(s)
- Stefan Latz
- Department of Urology, University of Bonn, Bonn, Germany
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30
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Silva CHW, Claros OR, Amselem I, Sá NS, Fugita OEH. Spindle-cell carcinoma of the prostate. AUTOPSY AND CASE REPORTS 2012; 2:55-61. [PMID: 31528563 PMCID: PMC6735638 DOI: 10.4322/acr.2012.009] [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: 02/27/2012] [Accepted: 03/03/2012] [Indexed: 11/24/2022] Open
Abstract
Sarcoma of the prostate and sarcomatoid carcinoma of the prostate are rare conditions, both characterized by a poor prognosis. Sarcomatoid carcinoma of the prostate typically arises from the evolution of an underlying adenocarcinoma, occasionally featuring heterologous elements, bulky disease being possible but rare. In contrast, sarcoma of the prostate derives from non-epithelial mesenchymal components of the prostatic stroma, shows rapid growth, and frequently presents as massive pelvic tumors obstructing the urinary tract at the time of diagnosis. We report the case of a 55-year-old patient with a two-month history of symptoms of urinary obstruction. The patient presented with an extremely enlarged heterogeneous prostate, although his prostate-specific antigen level was low. The lack of a history of prostatic neoplasia led us to suspect sarcoma, and a transrectal prostate biopsy was carried out. An immunohistochemical study of the biopsy specimen did not confirm the clinical suspicion. However, in view of the clinical features, we believe that sarcoma of the prostate was the most likely diagnosis. The patient received neoadjuvant chemotherapy followed by radiation therapy. At this writing, surgical resection had yet to be scheduled.
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Affiliation(s)
| | - Oliver Rojas Claros
- Department of Surgery - Hospital Universitário - Universidade de São Paulo - São Paulo/SP - Brazil
| | - Isaac Amselem
- Department of Urology - Hospital São Camilo - Santana - São Paulo/SP - Brazil
| | - Newton Soares Sá
- Department of Urology - Hospital São Camilo - Santana - São Paulo/SP - Brazil
| | - Oscar Eduardo Hidetoshi Fugita
- Department of Surgery - Hospital Universitário - Universidade de São Paulo - São Paulo/SP - Brazil.,Department of Urology - Hospital São Camilo - Santana - São Paulo/SP - Brazil
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31
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Qiu LL, Yu RS, Chen Y, Zhang Q. Sarcomas of abdominal organs: computed tomography and magnetic resonance imaging findings. Semin Ultrasound CT MR 2012; 32:405-21. [PMID: 21963162 DOI: 10.1053/j.sult.2011.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Sarcomas originating from abdominal organs are extremely rare, and literature in which investigators focus on their imaging features is scarce. This article aims to review the computed tomography and magnetic resonance imaging features of these rare tumors and to help in clinical diagnosis. Various sarcomas (eg, angiosarcoma, undifferentiated embryonal sarcoma, leiomyosarcoma, carcinosarcoma, rhabdomyosarcoma) originating, respectively, from different abdominal visceral organs (liver, pancreas, spleen, kidney, adrenal gland, uterus, and prostate gland) are reviewed along with cases we encountered.
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Affiliation(s)
- Ling-Ling Qiu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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32
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Muglia VF, Saber G, Maggioni G, Monteiro AJC. MRI findings of prostate stromal tumour of uncertain malignant potential: a case report. Br J Radiol 2011; 84:e194-6. [PMID: 21933974 PMCID: PMC3473770 DOI: 10.1259/bjr/67699443] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Prostatic stromal tumours are rare neoplasias that include benign, malignant and borderline lesions. Stromal tumour of uncertain malignant potential (STUMP) has been recently described and only a few reports exist in the literature. As a rare and distinct neoplasia, to date, there is no description of MRI findings of prostate STUMP. In this article, we describe the clinical and MRI features with histopathological correlation of a patient with prostate STUMP.
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Affiliation(s)
- V F Muglia
- Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
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Abstract
OBJECTIVE Lymphoma can affect virtually every tissue in the body, producing a variety of imaging appearances. In this article, the extranodal manifestations of this disease in the trunk and extremities are illustrated and the imaging features that aid in the diagnosis are reviewed. CONCLUSION Knowledge of the imaging appearances of extranodal lymphoma can aid the differential diagnosis of mass lesions encountered in tissues throughout the body on different imaging modalities.
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34
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Tamada T, Sone T, Miyaji Y, Kozuka Y, Ito K. MRI appearance of prostatic stromal sarcoma in a young adult. Korean J Radiol 2011; 12:519-23. [PMID: 21852915 PMCID: PMC3150682 DOI: 10.3348/kjr.2011.12.4.519] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 02/16/2011] [Indexed: 01/18/2023] Open
Abstract
Prostatic stromal sarcoma (PSS) is quite rare. Herein, we describe magnetic resonance imaging (MRI) features of a PSS identified in a 26-year-old man with dysuria and hematuria. MRI clearly depicted the extent and multinodular appearance of the tumor, which was mainly located in the central zone of the prostate. The tumor appeared as a heterogeneously signal-hyperintense mass with a pseudocapsule on T2-weighted imaging. Contrast-enhanced T1-weighted MRI showed necrotic portions in the gradually enhanced solid mass, and diffusion-weighted imaging permitted the accurate assessment of the local extent of the tumor. Thus, the appearance on MRI was quite different from that of adenocarcinoma of the prostate.
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Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan.
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Werner MK, Aschoff P, Reimold M, Pfannenberg C. FDG-PET/CT-guided biopsy of bone metastases sets a new course in patient management after extensive imaging and multiple futile biopsies. Br J Radiol 2011; 84:e65-7. [PMID: 21325361 PMCID: PMC3473865 DOI: 10.1259/bjr/26998246] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 04/07/2010] [Indexed: 11/05/2022] Open
Abstract
A 73-year-old man with a history of prostate and bladder carcinoma and persistent back pain was diagnosed by MRI with multiple vertebral metastases including a compression fracture of T7. He received radiotherapy for pain relief and for vertebral instability with incipient spinal stenosis, but additional targeted systemic therapy was intended. Therefore, multiple attempts at minimally invasive and open biopsies for histological characterisation of the bone metastases were performed, but failed to provide a conclusive specimen, although CT, MRI and bone scintigraphy were used for biopsy planning. Only histopathological analysis of an (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT-guided additional biopsy at a site with high metabolic activity yielded the final diagnosis of bone metastases of a neuroendocrine small cell cancer of unknown origin; hence, the patient had a third malignancy requiring a different therapy regimen and diagnostic work-up.
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Affiliation(s)
- M K Werner
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Medical Center, Tübingen, Germany.
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Dalle Carbonare L, Gasparetto A, Donatelli L, Dellantonio A, Valenti MT. Telomerase mRNA detection in serum of patients with prostate cancer. Urol Oncol 2011; 31:205-10. [PMID: 21353795 DOI: 10.1016/j.urolonc.2010.12.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/07/2010] [Accepted: 12/28/2010] [Indexed: 02/03/2023]
Abstract
Telomerase functions as a reverse transcriptase enzyme in the process of telomere synthesis and telomerase activity have been detected in a large part of neoplastic tissues, whereas in normal somatic cells they were low or undetectable. The aim of this study was to investigate the telomerase mRNA detection in the serum of patients with a prostate tumor by using real-time reverse transcription PCR. The results were compared with biological samples obtained by age-matched normal donors and by patients with cardiovascular or metabolic diseases. Our data demonstrated that telomerase mRNA is detectable in the serum of patients with prostate cancer whereas it is not amplifiable in normal donors. This marker, assayed with the molecular method of quantitative PCR in serum, may be useful for diagnosing and monitoring prostate cancer patients.
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Abstract
BACKGROUND High-grade prostatic intraepithelial neoplasia (HGPIN) is currently the only recognized premalignant lesion of prostatic carcinoma. METHODS This review article discusses HGPIN, its link to prostatic adenocarcinoma, and the significance of its presence on needle biopsy. The criteria and clinical impact of the diagnosis of atypical small acinar proliferation on needle biopsy are reviewed. Certain subtypes of prostate cancer that are not associated with HGPIN are of clinical relevance, and the unique clinicopathologic features of these subtypes are discussed. Histologic variants of prostatic adenocarcinoma with distinct cell types are also described. RESULTS HGPIN is the only known pathologic factor currently available to distinguish which patients may be at risk for detecting carcinoma on repeat biopsy. Histologic variants are recognized due to the inference of a particular Gleason grade pattern associated with the cell type, hence affecting prognosis. Typically, pure forms of these histologic variants are associated with worse prognosis due to the associated high Gleason grades. CONCLUSIONS HGPIN has a strong association with acinar-type prostatic adenocarcinoma. HGPIN and acinar-type prostatic adenocarcinoma both show similar molecular alterations, providing further evidence of their association.
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Tamada T, Sone T, Miyaji Y, Kozuka Y, Ito K. MRI Appearance of Prostatic Stromal Sarcoma in a Young Adult. Korean J Radiol 2011. [DOI: 10.3348/kjr.2011.12.4.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Teruki Sone
- Department of Radiology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Yoshiyuki Miyaji
- Department of Urology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Yuji Kozuka
- Department of Pathology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Katsuyoshi Ito
- Department of Radiology, Kawasaki Medical School, Okayama 701-0192, Japan
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Current status of MRI for the diagnosis, staging and prognosis of prostate cancer: implications for focal therapy and active surveillance. Curr Opin Urol 2009; 19:274-82. [PMID: 19325494 DOI: 10.1097/mou.0b013e328329a2ed] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW To review the current status of MRI techniques in identification of organ-confined prostate cancer with a focus on their implication for focal therapy and active surveillance. RECENT FINDINGS MRI is currently focusing on intraprostatic prostate cancer identification and at 1.5T, it provides excellent imaging of the whole gland including the challenging anterior part. Improvements in accuracy for cancer detection and volume estimation result from dynamic contrast-enhanced and diffusion-weighted MRI sequences. 3T MRI might improve cancer identification. Histological correlations showed high sensitivity and specificity for significant volume cancers larger than 0.5 cm3. Important knowledge on modelling of cancer morphology such as zone of origin and intraprostatic patterns of spread at histopathology was made available for imaging interpretation and treatment planning decision. MRI results allow focused use of biopsy which led to better cancer characterization such as extent and grade. Ongoing focal therapy protocols and active surveillance treatments should benefit from these imaging advances. SUMMARY At present, high-resolution MRI with pelvic coil appears to offer the most readily available and useful imaging. Future studies should work towards helping define standard, reproducible approaches to imaging and image reporting for research and clinical practice.
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