A case of malignant paraganglioma of the prostate, metastatic to the retroperitoneal area, is reported. The literature is reviewed and the possible origin of the disease is discussed. We believe that this is the first report of this entity of prostatic origin.
a 66-year-old white male, suffered crainiocerebral and L4 trauma in 1962 in an automobile accident. He had been followed at LBV AH for intermittent urinary tract infections secondary to a neurogenic bladder. Sometime after admission, the patient complained of left hip pain. X-rays revealed a fractured left femur with blastic lesions. A urology consult was obtained and a rock hard prostate with extension to the left was noted. An acid phosphatase was 28 (nl. to 0'8) and bone scan confirmed the blastic lesions. A prostatic needle biopsy was performed which revealed carcinoma of the prostate ( fig. la). The patient was placed on diethylstil besterol. Shortly thereafter he began to deteriorate with sepsis complicated by congestive heart failure, and a rising BUN and creatinine. He expired on 23 September 1974.A postmortem examination revealed adenocarcinoma of the prostate with metastases to the bladder, pelvic floor, pericardium, left and right atrial appendages, adrenals, subpleural tissues and left testicle. In addition, severe bilateral hydronephrosis was present. Histologic sections of the tumour revealed poorly differentiated carcinoma of the prostate (fig. Ib). 2. H. M., a 53-year-old white male is a C7 paraplegic secondary to an automobile accident in 1971. He was admitted to LBVAH in June 1974 with a history of difficulty emptying his bladder for one month. Two years prior to admission, the patient had had a transurethral resection of his prostate with a sphincterotomy. Physical examination revealed an alert, oriented male and was normal except for his myelopathy. His prostate was grade one-half without nodules. Laboratory data included: CBC, Hct. 38 per cent, WBC 8600; Urinalysis 10-15 WBC's. SMA-6 and SMA-12 were within normal limits. Acid phosphatase was 0'3 and 0'2 on two separate determinations (nl. to 0'8). A cysto scopy revealed an obstructive prostrate and he underwent a transurethral resection of his prostate, with removal of about 10 grams of tissue.
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