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Rieger C, Pfister D, Kastner L, Eich ML, Quaas A, Tolkach Y, Heidenreich A. Cystic Pelvic Masses in Men: A Presentation of Uncommon Cases and a Literature Review. Clin Genitourin Cancer 2024; 22:523-534. [PMID: 38281876 DOI: 10.1016/j.clgc.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/07/2024] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
Unclear cystic masses in the pelvis in male patients are a rare situation and could be of benign or malignant origin. The underlying diseases demand for specific diagnostic and therapeutic approaches. We present a case series of 3 male patients with different clinical symptoms (perineal pain, urinary retention and a large scrotal cyst) related to cystic lesions in the pelvic region. On all patients initial histopathological workup was unclear. All patients underwent surgery with complete resection of the tumor which revealed a broad spectrum of histopathological findings: unusual form of cystic adenocarcinoma of the prostate, malignant transformation of a dysontogenetic cyst, and finally a very rare diagnosis of a malignant tumor of the Cowper gland. This case series and literature review provide clues for a possible diagnostic and therapeutic approach in the case of unclear pelvic cystic masses and could support urologists during the therapy selection in the future.
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Affiliation(s)
- Constantin Rieger
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany.
| | - David Pfister
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Lucas Kastner
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Marie-Lisa Eich
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Yuri Tolkach
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
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2
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Talluri S, Hwang A, Mikhail M, Hessler R, Singh A. A rare case of ductal variant multilocular prostatic cystadenocarcinoma invading the rectum. Urol Case Rep 2023; 51:102597. [PMID: 37942212 PMCID: PMC10628349 DOI: 10.1016/j.eucr.2023.102597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/08/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
Prostate papillary and cribriform ductal prostatic adenocarcinoma is a rare malignancy infrequently reported in the literature. We describe a case of rectally invasive prostate cystic adenocarcinoma and surgical extirpative management not requiring fecal or urinary diversion.
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Affiliation(s)
- Sriharsha Talluri
- University of Tennessee College of Medicine – Chattanooga, 979 East Third Street, Suite C-925, Chattanooga, TN, 37403, USA
| | - Alex Hwang
- University of Tennessee College of Medicine – Chattanooga, 979 East Third Street, Suite C-925, Chattanooga, TN, 37403, USA
| | - Mark Mikhail
- University of Tennessee College of Medicine – Chattanooga, 979 East Third Street, Suite C-925, Chattanooga, TN, 37403, USA
| | - Richard Hessler
- Erlanger Health System, Department of Pathology, 975 East Third Street, Chattanooga, TN, 37403, USA
| | - Amar Singh
- University of Tennessee College of Medicine – Chattanooga, 979 East Third Street, Suite C-925, Chattanooga, TN, 37403, USA
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3
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Lima BB, Miranda BSP, Ramos DJ, Lopes B, Pereira TM, Franco TR, Pozzobon R, Fighera RA, Feliciano MAR. Hemorrhagic prostatic cyst in a dog - case report. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2023; 45:e005122. [PMID: 36660768 PMCID: PMC9841916 DOI: 10.29374/2527-2179.bjvm005122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
We present the case of a five-year-old intact mixed breed male dog with hemorrhagic prostatic cysts. The patient presented with hematuria, dysesthesia, and pain on abdominal palpation. Abdominal ultrasound, hematology, urinalysis, and biochemical evaluation tests were subsequently conducted. Laboratory tests revealed cloudy urine with bacteria, and countless red blood cells. On ultrasound examination, the prostate was severely enlarged, with heterogeneous and reduced parenchyma, surrounding a large cavity filled with anechoic material with moderate cellularity. The urinary bladder was markedly distended and had a round, hypoechogenic structure in the lumen. The patient was hospitalized and had significant, irreversible worsening of the clinical symptoms and died. Subsequently, necropsy of the patient was performed and a histopathological diagnosis of benign prostatic hyperplasia associated with the presence of a prostatic hemorrhagic cyst, prostatitis, and chronic cystitis with an intraluminal blood clot was made. To the best of our knowledge, this is the first report to describe the occurrence of a hemorrhagic cyst in a canine prostate, thus bringing important information from clinical and imaging findings to the veterinary routine.
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Affiliation(s)
- Bruna Bressianini Lima
- Veterinarian, MSc., Programa de Pós-Graduação em Ciências Veterinárias (PPGCV). Departamento de Cirurgia, Faculdade de Ciências Agrárias e Veterinárias (FCAV/Unesp), Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp/Jaboticabal), Jaboticabal, SP, Brazil
| | - Brenda Santos Pompeu Miranda
- Veterinarian, MSc., Programa de Pós-Graduação em Ciências Veterinárias (PPGCV). Departamento de Cirurgia, Faculdade de Ciências Agrárias e Veterinárias (FCAV/Unesp), Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp/Jaboticabal), Jaboticabal, SP, Brazil
| | - Denise Jaques Ramos
- Veterinarian, MSc., Programa de Pós-Graduação em Ciências Veterinárias (PPGCV). Departamento de Cirurgia, Faculdade de Ciências Agrárias e Veterinárias (FCAV/Unesp), Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp/Jaboticabal), Jaboticabal, SP, Brazil
| | - Bibiana Lopes
- Veterinarian, Resident. Programa de Residência em área profissional da saúde, modalidade uniprofissional - Medicina Veterinária - Diagnóstico por Imagem (PRAPS-MV/DI). Departamento de Clínica de Grandes Animais, Universidade Federal de Santa Maria (UFMS), Santa Maria, RS, Brazil
| | - Tainara Morais Pereira
- Veterinarian, Resident. Programa de Residência em área profissional da saúde, modalidade uniprofissional - Medicina Veterinária - Diagnóstico por Imagem (PRAPS-MV/DI). Departamento de Clínica de Grandes Animais, Universidade Federal de Santa Maria (UFMS), Santa Maria, RS, Brazil
| | - Tamara Rodrigues Franco
- Veterinarian, Resident. Programa de Residência em área profissional da saúde, modalidade uniprofissional - Medicina Veterinária - Patologia Clínica (PRAPS-MV/PC). Departamento de Clínica de Pequenos Animais (DCPA), UFSM, Santa Maria, RS, Brazil.
| | - Ricardo Pozzobon
- Veterinarian, DSc., Departamento de Clínica de Grandes Animais (DCGA), UFSM, Santa Maria, RS, Brazil.
| | | | - Marcus Antônio Rossi Feliciano
- Veterinarian, DSc., Faculdade de Zootecnia e Engenharia de Alimentos (FZEA), Universidade de São Paulo, SP, Brazil.,Correspondence
Marcus Antônio Rossi Feliciano
Departamento de Medicina Veterinária, Laboratório de Imaginologia Veterinária, Faculdade de Zootecnia e Engenharia de Alimentos - FZEA, Universidade de São Paulo - USP
Av. Duque de Caxias Norte, 225, Campus Fernando Costa
CEP 13635-900 - Pirassununga (SP), Brasil
E-mail:
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4
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Popov SV, Orlov IN, Chernysheva DY, Malevich SM. Cystic Prostatic Carcinoma - A Clinical Case and Literature Review. Res Rep Urol 2021; 13:335-340. [PMID: 34113581 PMCID: PMC8185564 DOI: 10.2147/rru.s312566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022] Open
Abstract
Cystic formations in the prostate are quite common, but the vast majority are benign. The cystic form of prostate adenocarcinoma can present unexpected symptoms, and management can be difficult because of the local advanced stage of the disease. A unique feature of this case is the surgical local cancer treatment. In this clinical case, we describe the literature surrounding this rare form of neoplasm. We present a clinical case of a rare form of prostate cancer in a 71-year-old male who was admitted to ER with acute urinary retention. A huge obstructing prostatic cyst was revealed. After successful trial-without-catheter, the patient underwent transperineal cyst draining and this restored urination. PSAt was increased up to 55 ng/mL. The cystic wall biopsy revealed adenocarcinoma with a Gleason score of 8 (4+4) (Gleason Group IV), and distant metastasis was noticed with PSMA PET/CT. The patient started androgen deprivation therapy (ADT) with excellent PSA dynamics in three months. Because of lower urinary tract symptoms, he needed local treatment and underwent radical prostatectomy. A three-month follow-up demonstrated a common post-operative period, mild stress incontinence, and PSAt 0.004 ng/mL. Cystic prostatic carcinoma can manifest as urinary retention and be mistakenly taken for a benign obstructing prostate cyst. Despite the locally advanced tumor, it can be successfully treated locally in highly selected patients.
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Affiliation(s)
- Sergey V Popov
- Urology Department, St. Luke's Clinical Hospital, Saint-Petersburg, Russia.,Urology Department, Military Medical Academy Named After S.M. Kirova, Saint-Petersburg, Russia.,Hospital Surgery Department, Saint-Petersburg State University, Saint-Petersburg, Russia
| | - Igor N Orlov
- Urology Department, St. Luke's Clinical Hospital, Saint-Petersburg, Russia.,Urology Department, North-Western State Medical University Named After I.I. Mechnikov, Saint-Petersburg, Russia
| | | | - Sergey M Malevich
- Urology Department, St. Luke's Clinical Hospital, Saint-Petersburg, Russia
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Veerman H, van Leeuwen PJ, Bekers E, van der Poel HG. Case of the month from the Netherlands Cancer Institute, Amsterdam: how to differentiate between benign and malignant prostatic cysts. BJU Int 2020; 126:240-244. [PMID: 32776450 DOI: 10.1111/bju.15156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Hans Veerman
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Department of Urology, Location VU Medical Centre, Amsterdam University Medical Centres, Amsterdam, The Netherlands.,Prostate Cancer Network Netherlands, Amsterdam, The Netherlands
| | - Pim J van Leeuwen
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Prostate Cancer Network Netherlands, Amsterdam, The Netherlands
| | - Elise Bekers
- Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Prostate Cancer Network Netherlands, Amsterdam, The Netherlands
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