Chen Jing, Quan Chang-Yi, Chang Ji-Wu, Yang Yu-Ming, Li Bo, Chang Wen-Liang, Wang Jiang, Niu Yuan-Jie
Tianjin Institute of Urology, Tianjin Medical University, Tianjin 300211, China.
Zhonghua Nan Ke Xue. 2011 Sep;17(9):825-8.
To study the clinical manifestations, pathological characteristics and treatment methods of prostate cancer with five different histological features.
We reported 1 case of prostate cancer with five different histological features and further analyzed the diagnosis, pathology and treatment of the disease by reviewing the relevant literature.
The patient was an 84-year-old male, admitted due to difficult urination and dribbling urine for 1 year, hematuria for 8 months and deterioration for 2 weeks. Prostate cancer was indicated by rectal examination, ultrasonography, CT, MRI and PSA, and confirmed by biopsy. Considering the general condition of the patient, we performed electrotransurethral resection under epidural anesthesia to alleviate his urinary symptoms and remove suspected tumor tissues. Postoperative pathology showed the case to be prostate adenocarcinoma, histologically characterized by cribriform carcinoma, acinar carcinoma, diffuse invasive carcinoma, ductal carcinoma, and mucinous adenocarcinoma, with a Gleason score of 9. Bicalutamide and goserelin were administered postoperatively. Systemic metastasis occurred 10 months later, and the patient died 1 year after the operation.
Prostate cancer with five different histological features is extremely rare. Its early diagnosis is difficult and mainly depends on pathological and immunohistochemical examinations, and radical prostatectomy can be considered for its treatment.
研究具有五种不同组织学特征的前列腺癌的临床表现、病理特征及治疗方法。
报告1例具有五种不同组织学特征的前列腺癌病例,并通过复习相关文献进一步分析该疾病的诊断、病理及治疗情况。
患者为84岁男性,因排尿困难、尿滴沥1年,血尿8个月,病情加重2周入院。经直肠指检、超声、CT、MRI及前列腺特异抗原(PSA)检查提示前列腺癌,活检确诊。考虑患者一般情况,于硬膜外麻醉下行经尿道电切术,以缓解其排尿症状并切除可疑肿瘤组织。术后病理显示为前列腺腺癌,组织学表现为筛状癌、腺泡癌、弥漫浸润癌、导管癌及黏液腺癌,Gleason评分9分。术后给予比卡鲁胺和戈舍瑞林治疗。10个月后发生全身转移,患者术后1年死亡。
具有五种不同组织学特征的前列腺癌极为罕见。其早期诊断困难,主要依靠病理及免疫组化检查,治疗可考虑行前列腺根治术。