Department of Pathology, The Methodist Hospital, Houston, Texas, USA.
Arch Pathol Lab Med. 2010 Sep;134(9):1271-5. doi: 10.5858/2009-0338-CR.1.
We report a case of ectopic prostate tissue with an associated prostatic adenocarcinoma occurring in the dome of the urinary bladder. A 62-year-old man presented with a 4-month history of persistent microscopic hematuria following a urinary tract infection. Other complaints included frequent urination, but there was neither dysuria nor gross hematuria. Digital rectal examination revealed a smooth prostate of normal size. Cystoscopic examination revealed a sessile lesion of the anterior bladder neck and multiple smaller papillary lesions throughout the bladder. Following a transurethral resection of the bladder tumor with a diagnosis of muscle-invasive transitional cell carcinoma grade 3, a radical cystoprostatectomy was performed. The diagnosis of transitional cell carcinoma was confirmed, but in addition, a different lesion was also incidentally found in the dome of the bladder. This incidental lesion showed a prostatic adenocarcinoma arising from ectopic prostatic tissue within the bladder submucosa. The prostate also showed prostatic adenocarcinoma, but this was minimal, low grade, and confined to the prostate gland, and thus it was felt to be unlikely to have metastasized to the bladder dome. Adenocarcinoma arising in ectopic prostatic tissue is a rare finding and to our knowledge only 1 case has been previously described, occurring in the soft tissue adjacent to the prostate. We report the first case of adenocarcinoma arising in ectopic prostatic tissue within the bladder.
我们报告了一例发生在膀胱顶部的异位前列腺组织伴发前列腺腺癌。一名 62 岁男性，在尿路感染后出现持续镜下血尿 4 个月。其他症状包括尿频，但无尿痛或肉眼血尿。直肠指检发现前列腺大小正常，表面光滑。膀胱镜检查显示膀胱颈前有一息肉状病变，膀胱内有多个较小的乳头状病变。经尿道膀胱肿瘤电切术后诊断为肌层浸润性移行细胞癌 3 级，随后行根治性膀胱前列腺切除术。诊断为移行细胞癌，但此外，还意外地在膀胱顶部发现了另一个病变。这个意外的病变显示出来源于膀胱黏膜下层异位前列腺组织的前列腺腺癌。前列腺也显示出前列腺腺癌，但程度轻微，为低级别，局限于前列腺内，因此不太可能已转移到膀胱顶部。发生在异位前列腺组织中的腺癌是一种罕见的发现，据我们所知，以前仅描述过 1 例，发生在前列腺旁的软组织中。我们报告首例发生在膀胱内异位前列腺组织中的腺癌。
