Macrocystic ductal adenocarcinoma of prostate: A rare gross appearance of prostate cancer

A 66-year-old male visited with constipation. Intra-pelvic cystic mass (332 cm 3 ) was found, and PSA was 32.4 ng/ml. Biopsy of the prostate was performed. It wasn't adequate specimen for diagnosis, but the PSA of the fluid was 4791.0 ng/ml. RARP was performed. To make surgical field more visible, fine needle was stuck from the patient's perineum into the cyst intraoperatively. The patient was discharged with nothing complications. It was mucinous adenocarcinoma of the prostate, pT3b, RM1. The patient is now receiving ADT but no recurrence and metastasis are seen to date.

show abstract

“…The frequency of cyst formation in PCa is reported 0.32% 4 ) . Some of them were due to intra-tumor necrosis or hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

A case of cystic mucinous adenocarcinoma of the prostate treated by robot-assisted radical prostatectomy

Seito

Ishikawa

Tsuru

et al. 2022

Urology Case Reports

View full text Add to dashboard Cite

show abstract

“…Findings useful in establishing a diagnosis of malignancy within microcystic glands include nuclear atypia, AMACR overexpression, lack of basal cells, and adjacent small acinar adenocarcinoma. Ductal adenocarcinomas of the prostate may also show cystic dilatation of the malignant glands, which can occasionally be seen microscopically and macroscopically [27,28]. However, they differ from microcystic acinar adenocarcinomas in that the cysts are typically large (5-10 mm) and show intracystic papillae [16,27].…”

Section: Microcystic Variantmentioning

confidence: 99%

Histologic variants of acinar prostate carcinomas: Clinicopathologic importance

Singh

El-Zaatari

2020

ann urol oncol

View full text Add to dashboard Cite

Acinar carcinoma comprises more than 90% of prostatic adenocarcinomas and is characterized by a small gland proliferation with an infiltrative growth pattern. The numerous, variably-defined histological variants of prostatic adenocarcinoma can prove to be diagnostic challenges and show prognostic differences when compared to the usual acinar carcinoma, thus emphasizing the importance in accurate recognition. Variants of acinar prostatic adenocarcinoma include the atrophic, pseudohyperplastic, microcystic, foamy gland, mucinous (colloid), signet ring-like cell, pleomorphic giant cell, and sarcomatoid variants. The atrophic, pseudohyperplastic, microcystic, and foamy gland variants can be challenging to diagnose due to their deceptively benign appearance. While the atrophic, pseudohyperplastic, microcystic, and foamy gland variants usually present as low-grade malignancies (Gleason score 6-7), the mucinous (colloid), signet ring-like cell, pleomorphic giant cell, and sarcomatoid variants often present as high-grade malignancies (Gleason score >7) and are usually associated with a worse prognosis. Small cell carcinoma is not considered as a variant of acinar carcinoma, is classified under neuroendocrine tumors, and is recommended not to be assigned a Gleason score. Small cell carcinoma is often preceded by a diagnosis of acinar adenocarcinoma, rarely presents as a de novo tumor, and, as in other organs systems has an aggressive clinical course. In this review article, we discuss variants of prostatic acinar carcinomas and briefly discuss small cell carcinoma. Awareness of variants of acinar prostate carcinoma and their clinicopathologic features is essential to rendering an accurate diagnosis and clinical management of patients with these tumors.

show abstract

“…Cystic dilatation of malignant prostatic glands can also be seen in ductal adenocarcinoma, where the cystic change can be microscopic or macroscopic. 33,34 Microscopic cystic ductal adenocarcinomas have been termed cystadenocarcinomas. 34 These cystically dilated ductal adenocarcinomas differ from microcystic acinar adenocarcinomas in that the cysts are larger (at 5-10 mm) and exhibit intracystic papillae.…”

Section: Microcystic Adenocarcinomamentioning

confidence: 99%

Variants of acinar adenocarcinoma of the prostate mimicking benign conditions

Humphrey

2018

Modern Pathology

View full text Add to dashboard Cite

Histological variants of acinar adenocarcinoma of the prostate may be of significance due to difficulty in diagnosis or due to differences in prognosis compared to usual acinar adenocarcinoma. The 2016 World Health Organization classification of acinar adenocarcinoma includes four variants that are deceptively benign in histological appearance, such that a misdiagnosis of a benign condition may be made. These four variants are atrophic pattern adenocarcinoma, pseudohyperplastic adenocarcinoma, microcystic adenocarcinoma, and foamy gland adenocarcinoma. They differ from usual small acinar adenocarcinoma in architectural glandular structure and/or cytoplasmic and nuclear alterations. The variants are often admixed, in variable proportions, with usual small acinar adenocarcinoma that is often Gleason pattern 3 but may be high-grade pattern 4 in a minority of cases. Atrophic pattern adenocarcinoma can be identified in a sporadic setting or after radiation or hormonal therapy. This variant is characterized by cytoplasmic volume loss and can resemble benign glandular atrophy, an extremely common benign process in the prostate. The glands of pseudohyperplastic adenocarcinoma simulate usual epithelial hyperplasia, with gland complexity that is not typical of small acinar adenocarcinoma. These complex growth configurations include papillary infoldings, luminal undulations, and branching. Microcystic adenocarcinoma is characterized by cystic dilation of prostatic glands to a size that is much more commonly observed in cystic change in benign prostatic glands. Finally, the cells in foamy gland adenocarcinoma display cytoplasmic vacuolization and nuclear pyknosis, features that can found in benign glands and macrophages. Three of the four variants (atrophic, pseudohyperplastic, and microcystic) are assigned low-grade Gleason pattern 3. Of significance, foamy gland adenocarcinoma can be Gleason pattern 3 but can also be high-grade pattern 4 or 5. Diagnostic awareness of the existence of these deceptively benign-appearing variants of acinar adenocarcinoma is essential so that an accurate diagnosis of prostate cancer may be rendered.

show abstract

Macrocystic ductal adenocarcinoma of prostate: A rare gross appearance of prostate cancer

Cited by 7 publications

References 21 publications

A case of cystic mucinous adenocarcinoma of the prostate treated by robot-assisted radical prostatectomy

A case of cystic mucinous adenocarcinoma of the prostate treated by robot-assisted radical prostatectomy

Histologic variants of acinar prostate carcinomas: Clinicopathologic importance

Variants of acinar adenocarcinoma of the prostate mimicking benign conditions

Contact Info

Product

Resources

About