Kim S C, Fujimoto K, Matsumoto Y, Cho M, Natsume O, Uemura H, Ozono S, Hirao Y
Department of Urology, Nara Medical University.
Hinyokika Kiyo. 2001 Sep;47(9):653-6.
A 73-year-old man with the complaint of dysuria of 2 years' standing was admitted to our hospital for further examination of an intrapelvic cystic mass, 8.6 cm in diameter, detected incidentally by abdominal ultrasonography. The serum concentration of prostate specific antigen (PSA) was elevated to 44.9 ng/ml. Pelvic computed tomography (CT) and magnetic resonance imaging (MRI) revealed a cystic mass with an irregular thick cyst wall posterior to the urinary bladder originating from the prostate. Transrectal needle biopsy presented a moderately differentiated adenocarcinoma of the prostate. The bloody fluid of the cyst obtained by transperineal aspiration contained a significantly increased level of PSA, but no cancer cells were detected by cytological examination. Total prostatectomy was performed under the diagnosis of clinical stage C (cT3N0M0) prostate cancer. Pathological diagnosis was that cancer cells were present in the prostate tissue and had partly infiltrated the cyst wall. These results suggest that the present cyst was associated with the development of prostate cancer as a pseudocyst without an epithelial lining. The patient has remained free from the disease for over ten months. We review 56 cases of this rare condition that have been reported in Japan.
一名73岁男性,有2年排尿困难主诉,因腹部超声偶然发现盆腔内直径8.6 cm的囊性肿块而入院进一步检查。血清前列腺特异性抗原(PSA)浓度升高至44.9 ng/ml。盆腔计算机断层扫描(CT)和磁共振成像(MRI)显示膀胱后方有一个囊性肿块,起源于前列腺,囊肿壁不规则增厚。经直肠穿刺活检显示为中度分化的前列腺腺癌。经会阴穿刺抽取的囊肿血性液体中PSA水平显著升高,但细胞学检查未检测到癌细胞。在临床分期为C期(cT3N0M0)前列腺癌的诊断下进行了前列腺全切术。病理诊断为前列腺组织中有癌细胞,且部分浸润了囊肿壁。这些结果表明,目前的囊肿是与前列腺癌发展相关的无上皮内衬的假性囊肿。该患者已无病生存超过十个月。我们回顾了日本报道的56例这种罕见病例。