Prostate adenocarcinoma associated with prostatic infection due to Schistosoma haematobium. Case report and systematic review

Abstract

Schistosomiasis affects more than 240 million people worldwide, an infection which may cause urogenital manifestations including, among others, squamous bladder cancer and prostate involvement. We describe the first case of a prostate adenocarcinoma associated with prostatic Schistosoma haematobium infection occurring in Angola. Prostate carcinoma was suspected because of high levels of prostate-specific antigen. This observation prompted us to review the literature on schistosomiaisis with respect to genital pathology and prostate cancer. Described genital manifestations in men include funiculitis, epididymitis, granulomata of the seminal vesicles, testicular masses, and prostate lesions which may cause haematospermia and infertility. In contrast to bladder cancer, only 12 reports including the present case on 17 cases on prostate carcinoma associated with schistosomiasis have been published worldwide. The rarity of reports on prostate carcinoma associated with schistosomiasis is partly due to diagnostic constraints, and its incidence is underestimated. However, in emerging countries, the incidence of prostate cancer appears to increase mainly as a result of urbanization and improved access to health care where schistosomiasis prevalence is decreasing.

Rare Association between Prostate Adenocarcinoma and Schistosomiasis: A Case Report

“…In endemic areas, the poor access to appropriate health care as well as the interpretation of hematuria and hematospermia as a sign of sexual maturity could justify the underdiagnosis of this association. 1 Even because the probability of these two frequent conditions to rise individually should be greater than the one reported on these studies. 1 We wanted to share this case not just for its rarity, but also because may indicate prostate cancer as a potential uncommon complication of an untreated urinary schistosomiasis.…”

“…1 Even because the probability of these two frequent conditions to rise individually should be greater than the one reported on these studies. 1 We wanted to share this case not just for its rarity, but also because may indicate prostate cancer as a potential uncommon complication of an untreated urinary schistosomiasis. As there is some controversy on this topic further investigation to clarify this possible causal relationship is advised.…”

“…5 To data only 17 cases of prostatic adenocarcinoma and concomitant gland schistosomiasis have been described (S. haematobium identified in 11 cases, S. mansoni in five cases and not specified in one case). 1 As an uncommon potential complication of an untreated schistosomiasis, we present a case report of simultaneous prostatic adenocarcinoma and urinary schistosomiasis incidentally diagnosed after a radical prostatectomy in a 62-year--old African man living in a non-endemic area.…”

“…1 It is common in developing countries with poor sanitation, especially from Africa and Asia (eg. Egypt and China), but is rare in Europe.…”

“…2 It penetrates the skin and release eggs that can be excreted in faeces or urine or become trapped in body tissues, like intestine, bladder or reproductive organs, causing a chronic granulomatous response and progressive damage of those tissues. 1,3 Urogenital tract involvement is mainly due to Schistosoma haematobium. Schistosomiasis has long been associated with malignant neoplasia.…”