Fine needle aspiration of metastatic prostate carcinoma simulating a primary adrenal cortical neoplasm: A case report and review of the literature

Abstract

Adrenal metastases usually occur in prostate cancer patients with widespread bone and visceral disease. Autopsy studies have shown that adrenal metastases may be found in up to 23% of these patients. However, the finding of an isolated adrenal metastasis without the involvement of other organs in a patient with prostate cancer is exceedingly rare. Thus, it may cause a diagnostic dilemma on FNA cytology. We report a patient with a history of prostate cancer, status post radiation, and hormonal therapy 4 years before, who presented with a new, single adrenal mass on abdominal imaging studies. The ultrasound-guided FNA cytology of the adrenal mass revealed cytomorphological features that were suggestive of a primary adrenal cortical neoplasm, but overlapped with those of a prostate metastasis. To our knowledge, FNA findings of metastatic prostate cancer simulating an adrenal cortical neoplasm have not been previously reported in the English literature. The purpose of our study is to discuss the differential diagnosis of these entities. The accurate diagnosis is important because of different prognosis and treatment implications for the various diseases.

The utility of PSMA and PSA immunohistochemistry in the cytologic diagnosis of metastatic prostate carcinoma

“…Although the diagnosis of welldifferentiated metastatic prostate cancers can be straightforward, the diagnosis of higher-grade, poorly differentiated tumors can be challenging. 8 Compounding this problem, studies have shown that metastatic prostate carcinoma can present in a different morphologic pattern compared to that of the primary tumor. [9][10][11][12] Thus, immunohistochemistry can serve as a useful adjunct in this regard.…”

Fine‐needle aspiration for proteomic study of tumour tissues

“…FNA has been demonstrated to be an accurate, rapid, minimally invasive and cost‐effective technique for the cytological diagnosis of mass lesions in various organs and tissues. Many reviews on this topic are present in the literature, and in Table 1 we have summarized the most recent and significant ones 3–43.…”

68Ga-PSMA-11 PET/CT in Isolated Bilateral Adrenal Metastases From Prostate Adenocarcinoma

“…Adrenal metastasis from prostate cancer is atypical and usually occurs in wide dissemination of the disease 1,2 . However, isolated adrenal metastasis from prostate cancer is extremely rare and may mimic primary adrenal tumor clinically and radiologically 3,4 . 68 Ga-PSMA PET/CT findings of adrenal metastasis from prostate adenocarcinoma have been rarely reported before.…”