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Mucinous adenocarcinoma of the prostatic urethra after brachytherapy for prostatic adenocarcinoma: a case series.
Zhao, Ting; Chuang, Hao-Wen; Cornejo, Kristine M; Crotty, Rory K; Dahl, Douglas M; Wszolek, Matthew F; Zlatev, Dimitar V; Zietman, Anthony L; Wu, Chin-Lee.
Afiliação
  • Zhao T; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Chuang HW; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Cornejo KM; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Crotty RK; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Dahl DM; Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Wszolek MF; Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Zlatev DV; Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Zietman AL; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
  • Wu CL; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. Electronic address: cwu2@mgh.harvard.edu.
Hum Pathol ; 128: 101-109, 2022 10.
Article em En | MEDLINE | ID: mdl-35926810
ABSTRACT
Mucinous adenocarcinoma of the urethra is extremely rare, even more so in a setting of postradiation therapy, with only 3 cases reported up to date including the first case published by our group in 2011. In the present study, we included the long-term follow-up on our previously reported case and report 3 additional cases. This is the first case series to date of this rare disease entity. The aim of this study is to review the clinicopathologic features of mucinous adenocarcinoma of the prostatic urethra in patients after receiving brachytherapy for prostatic adenocarcinoma. We identified 4 patients with a mean age of 72 years, and a mean interval of 14.8 years from brachytherapy for prostate carcinoma (grade group 1). Patients presented with hematuria or urinary retention. A colonoscopy was performed in three-fourth of patients and was within normal limits. Three patients underwent cystoprostatectomy and 1 had a transurethral resection of the prostate. On gross examination, only tumor formed a 3.5 cm tan-gray, ulcerated, friable, and necrotic mass and 2 displayed either irregular red granular or thickened areas within the prostatic urethra. Abundant extracellular mucin pools dissecting the prostatic stroma were present in all tumors, with clusters of tumor cells floating in the mucin. The mucin pools were lined by pleomorphic pseudostratified columnar mucinous epithelium. Tumors were diffusely positive for CK20, CDX2 (4/4), and AMACR (2/2); they focally expressed CK7 (2/4), and lacked nuclear ß-catenin expression (3/3). PSA, PSAP, NKX3.1, p63, and GATA3 were negative in the tumors tested. Among the 3 patients who underwent radical surgery, 2 had stage 2 tumors (confined to the prostatic urethra and prostate), and 1 had a stage 3 tumor, with seminal vesicle involvement. All 4 patients were alive without disease with a mean follow-up of 4.9 years. In conclusion, brachytherapy-associated mucinous adenocarcinoma of the prostatic urethra displays intestinal-type features as its non-radiation-related counterpart. It appears to lack a villous adenoma component, displays a different immunohistochemical profile with diffuse CK20 and CDX2 positivity, and is associated with lower stage and less aggressive behavior.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Adenocarcinoma Mucinoso / Ressecção Transuretral da Próstata Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Adenocarcinoma Mucinoso / Ressecção Transuretral da Próstata Idioma: En Ano de publicação: 2022 Tipo de documento: Article