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前列腺间质肉瘤伴横纹肌样特征。

Prostatic stromal sarcoma with rhabdoid features.

机构信息

Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 138-736 Seoul, Korea.

出版信息

Ann Diagn Pathol. 2010 Dec;14(6):453-6. doi: 10.1016/j.anndiagpath.2009.10.008. Epub 2010 Feb 4.

Abstract

Rhabdoid tumors have been reported in many different anatomic sites as an aggressive tumor and usually present with a rhabdoid tumor component (a composite tumor) rather than a pure rhabdoid tumor. Rhabdoid tumor in the prostate has been described only once in the prostatic region as a possible epithelial origin. Rhabdoid features in prostatic stromal sarcomas (PSSs) have never been described in the literature. Here, we report a case of a PSS with rhabdoid features. A 31-year-old man presented with a 4-month history of voiding difficulty and anal pain. Computed tomography of the abdomen revealed an ovoid mass in the prostate invading rectum and urinary bladder. A needle biopsy was diagnosed as an unclassified spindle cell sarcoma, and 2 cycles of adriamycin-based neoadjuvant chemotherapy were given, followed by radical prostatectomy. The prostatectomy specimen revealed a high-grade sarcoma with fascicles of highly cellular spindle cells and numerous mitoses with hemorrhage and necrosis. In areas, the tumor also contained sheets of loosely cohesive epithelioid cells with rhabdoid tumor component. Both spindle and rhabdoid tumor cells were positive for vimentin, CD34, and progesterone receptor and negative for desmin and cytokeratin immunostainings. The rhabdoid tumor cells retained INI1 expression. The tumor recurred in the bladder, and the patient died of sepsis. To the best of our knowledge, this is the first case of PSS with rhabdoid features. The tumor showed an aggressive clinical behavior with a short-term survival (7 months after diagnosis).

摘要

横纹肌样瘤已在许多不同的解剖部位被报道为一种侵袭性肿瘤,通常表现为横纹肌样瘤成分(复合性肿瘤)而不是纯横纹肌样瘤。前列腺内的横纹肌样瘤仅在前列腺区域被描述为可能的上皮起源。文献中从未描述过前列腺间质肉瘤(PSS)中的横纹肌样特征。在此,我们报告一例具有横纹肌样特征的 PSS。一名 31 岁男性因排尿困难和肛门疼痛 4 个月就诊。腹部计算机断层扫描显示前列腺内有一个卵圆形肿块,侵犯直肠和膀胱。针吸活检诊断为未分类的梭形细胞肉瘤,并给予 2 周期阿霉素为基础的新辅助化疗,随后行根治性前列腺切除术。前列腺切除术标本显示高级别肉瘤,有束状的高细胞性梭形细胞和大量有丝分裂,伴有出血和坏死。在某些区域,肿瘤还包含有松散聚集的上皮样细胞层,具有横纹肌样瘤成分。梭形和横纹肌样瘤细胞均对波形蛋白、CD34 和孕激素受体呈阳性,对结蛋白和细胞角蛋白免疫染色呈阴性。横纹肌样瘤细胞保留了 INI1 的表达。肿瘤在膀胱复发,患者死于脓毒症。据我们所知,这是首例具有横纹肌样特征的 PSS。该肿瘤表现出侵袭性的临床行为,生存时间短(诊断后 7 个月)。

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