Yoon Ghilsuk, Han Man-Hoon, Seo An Na
Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
J Pathol Transl Med. 2019 Jul;53(4):266-269. doi: 10.4132/jptm.2019.03.25. Epub 2019 Apr 11.
Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed alpha-methylacyl-CoA-racemase positivity, PSA positivity, and caudal-related homeobox 2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.
尽管在解剖位置上相邻，但前列腺腺癌侵犯直肠极为罕见。我们报告一例前列腺腺癌侵犯直肠的病例，该病例最初是在一名69岁韩国男性的结肠镜检查中对直肠息肉进行活检时确诊的。他出现了数天的肛门隐痛和排尿不适。计算机断层扫描显示要么是前列腺腺癌侵犯直肠，要么是直肠腺癌侵犯前列腺。他的肿瘤标志物检查显示前列腺特异性抗原（PSA）水平正常，而癌胚抗原水平显著升高。进行了结肠镜检查，并从距肛缘1.5厘米处的一个1.5厘米圆形无蒂息肉获取了标本。显微镜下，腺性肿瘤结构浸润至直肠黏膜和黏膜下层。免疫组化显示，肿瘤细胞α-甲基酰基辅酶A消旋酶呈阳性、PSA呈阳性、尾型相关同源盒2呈阴性。直肠息肉的最终诊断为前列腺腺癌。在此，我们呈现了一例可能被误诊为直肠腺癌的罕见病例。
