Background Prostate tumor involving the rectal wall is rare and may
July 17, 2017
Background Prostate tumor involving the rectal wall is rare and may lead to diagnostic pitfalls. reminiscent of rectal carcinoma. The tumors consisted of small-sized or foamy cells that formed acinus-like, duct-like, and cribriform-like structures. We conducted histological staining and an immunohistochemical analysis for CDX-2, prostate-specific antigen (PSA), P504s, villin, carcinoembryonic antigen, CK-pan, cytokeratin 20, and Ki-67. All tumors were PSA and CK-pan positive, Rabbit Polyclonal to MRPL11 5 of 9 tumors were P504s-positive, and all tumors were negative for the other markers. All patients underwent standard therapy for prostate cancer after the definitive pathological diagnosis. As of March 31, 2015, 8 patients were alive and 1 had died of prostate cancer 6?months posttreatment. Conclusions Adenocarcinoma appearing in 415713-60-9 supplier the rectal wall is not always rectal carcinoma. It is necessary to perform a differential diagnosis for prostate cancer in cases of rectal malignant tumors in elderly male patients. Any treatment should be postponed until the final definitive diagnosis is reached. History Prostate tumor may be the second most regularly diagnosed tumor as well as the 5th leading reason behind cancer loss 415713-60-9 supplier of life among men world-wide . In China, the occurrence price of prostate tumor was 1.6/100 000 individuals. Nevertheless, its occurrence continues to be increasing each full yr . Prostate tumor risk elements add a grouped genealogy of the condition, ethnicity, and in old age group  particular, with most instances occurring in males more than 50?years [4C6]. With an increase of extensive testing techniques being increasingly used in China, the incidence of prostate cancer may rapidly increase in the future . The prostate is located in the pelvis, under the urinary bladder and in front of the rectum. Because of its location, prostate cancer often affects urination, ejaculation, and more rarely, defecation. Prostate cancer may invade the nearby organs including the rectum, bladder, and ureters, and metastasize to the bones and lymph nodes [7C9]. The presenting symptoms include difficulty urinating, blood in the urine, and pelvic pain [10, 11]. Because of its proximity to the rectum, prostate cancer can be misdiagnosed as rectal cancer. There is a thick capsule (Denonvilliers fascia) between the prostate and rectal wall , and prostate cancer accompanied by rectal invasion is rare [13, 14]. In the present research, we retrospectively examined 9504 instances diagnosed as rectal tumor in our medical center from 2003 to 2015, and record the clinicopathological features of 9 instances of prostate tumor with rectal wall structure invasion misdiagnosed as rectal tumor. In these 9 individuals, the original symptoms in 8 individuals had been rectal urgency, colon blockage, and lower gastrointestinal bleeding, and prostate-related symptoms weren’t apparent. A definitive analysis of prostate tumor invading the rectum could be made predicated on the individuals background, the morphological top features of the tumor, and immunohistochemical (IHC) analyses. Furthermore, the serum prostate-specific antigen (PSA) amounts as well as the percentage of free of charge PSA to unbound PSA are a good idea to avoid a medical misdiagnosis . Case demonstration Individuals This research was authorized by the Institutional Review Panel of Tianjin Union Medication Middle, and the patients anonymity has been maintained. The surgical pathology database at the Department of Pathology 415713-60-9 supplier (2003C2015) was searched for cases of prostate cancer with rectal wall involvement. Nine elderly patients with such cancer, with a mean age of 74.75??7.19?years, were included. Specimens were obtained using biopsy in 5 patients, fine needle aspiration (FNA) in 3 patients, and surgical resection in 1 patient who underwent 3?months of chemotherapy prior to surgery to shrink the tumor. Clinical 415713-60-9 supplier findings and characteristics The clinical characteristics and macroscopic findings are summarized in Table?1. The mean affected person age group was 74?years (range, 64C85 years). Eight individuals (64.3%) had zero prior background of prostate tumor, whereas 1 had a brief history of prostate tumor (9?years earlier). Symptoms included a big change in bowel movements (n?=?4), rectal urgency (n?=?4), pelvic pain (n?=?1), rectal mass (n?=?2), and lower gastrointestinal bleeding (n?=?2). Only 1 1 patient had prostate-related symptoms including urinary frequency, difficulty in urination, and painful urination. Table 1 Clinical, demographic and macroscopic findings Endoscopy revealed that the tumor masses were located at 2C7?cm away from the anus, and ranged 1C6?cm in size. Grossly, the tumors included circumferential rectal masses (n?=?3), an ulceration lesion (n?=?1), a crater-like mass (n?=?1), and protruding lesions (n?=?4). In 7 patients, serum PSA levels were 6C10 times higher than the upper limit of the normal level; the PSA level was not recorded in 2 patients. The ratio of free PSA to unbound PSA.