Despite the high incidence of prostatic adenocarcinoma and its ability for wide dissemination, metastatic involvement of testis is rather uncommon. We report two cases (aged 76 and 55 years, respectively), where unilateral testicular metastasis was incidentally discovered after bilateral orchiectomy following detection of adenocarcinoma prostate in six-quadrant trucut specimen. Both patients had obstructive voiding symptoms, hard nodular prostate on direct rectal examination and raised serum prostate-specific antigen levels, without associated systemic or testicular symptoms. Extensive evaluation excluded any other possible primary, although axial skeletal metastasis was detected on radionucleotide bone scans, in the first case. These cases highlight the need for proper evaluation of testes and para-testicular structures, for accurate staging of these tumors and to exclude any possible metastasis.
Carcinomas of the esophagus are the sixth most common malignancy worldwide in males. Esophageal cancer occurs in two histological types: SCC and adenocarcinoma, 90% is SCC in developing countries. The presence of tumor budding (TB) at the tumor–host interface of gastrointestinal cancers has been recognized as a hallmark of unfavorable disease biology. TB is defined as the presence of isolated malignant cells or small clusters of up to five cells at the tumor invasive front. Methods The study done by taking formalin fixed paraffin blocks of 13 esophagectomy specimens from the year 2014-2019. TB score was calculated at the invasive front of the tumor in 200x magnification. 10 fileds were screened and a hotspot was found. <5 buds were taken as a low grade budding. ≥5 buds were taken as a high grade budding. Results The study showed that 53.85% were found to be males & 46.15% were females. In pT staging, T3 was the most common. 61.5% of the cases showed high grade budding while low grade budding was seen in only 38.5%. This tells us 69.2% fell under T3 stage of which 88.89% had high grade TB while only 11.11% had low grade budding. Of the 4 present cases of LVI, 75% had high grade TB & 25% had low grade budding. Of the 3 margin involved cases, 67% had high grade TB while 33% had low grade budding. Conclusion To conclude, TB is a valuable prognostic factor and indicator of aggressive diseases. Presence of TB correlates to unfavorable clinico-pathological features. It also provides an important value of risk stratification. 1. Risk stratification 2. High grade TB benefit from esophagectomy.
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