Sakamoto Naotaka, Ohtsubo Satoshi, Iguchi Atsushi, Takeshita Morishige, Kurozumi Takeshi
Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Int J Urol. 2005 May;12(5):509-12. doi: 10.1111/j.1442-2042.2005.01072.x.
We present a case of mucinous adenocarcinoma of intestinal type arising from the prostatic duct in a 72-year-old Japanese man. The patient presented with macroscopic hematuria. Cystourethroscopy exhibited a mucus deposit at the 5 o'clock position of the verumontanum portion. A transurethral biopsy specimen revealed mucinous adenocarcinoma. A radical retropubic prostatectomy was performed. In the prostatectomy specimen, the cancer lesion mainly showed intraductal growth in the prostatic ducts with scattered mucin lakes in the prostatic stroma. There were no abnormalities in the urethral epithelium. The cancer cells resembled the intestinal epithelium rather than either the prostatic duct or the acinar epithelium, which showed diffusely positive immunohistochemical staining for carcinoembryonic antigen, but showed negative staining for prostate-specific antigen. Therefore, these findings suggest mucinous adenocarcinoma of intestinal type arising from the prostatic duct. A number of cases with mucinous adenocarcinoma arising from the prostatic urethra resembling the present case have been reported, but this is the first known case of carcinoma arising from the prostatic duct.
我们报告一例72岁日本男性前列腺导管起源的肠型黏液腺癌病例。患者表现为肉眼血尿。膀胱尿道镜检查显示精阜部5点钟位置有黏液沉积。经尿道活检标本显示为黏液腺癌。行耻骨后根治性前列腺切除术。在前列腺切除标本中，癌灶主要表现为前列腺导管内生长，前列腺基质中有散在的黏液湖。尿道上皮未见异常。癌细胞类似于肠上皮，而非前列腺导管或腺泡上皮，癌胚抗原免疫组化染色弥漫阳性，但前列腺特异性抗原染色阴性。因此，这些发现提示为前列腺导管起源的肠型黏液腺癌。已有多例类似于本病例的前列腺尿道起源的黏液腺癌报道，但这是首例已知的前列腺导管起源的癌。
