Multilocular cystadenoma and cystadenocarcinoma of the prostate

doi:10.1016/j.urolonc.2006.01.011

Urologic Oncology: Seminars and Original Investigations

Volume 25, Issue 1, January–February 2007, Pages 19-25

https://doi.org/10.1016/j.urolonc.2006.01.011 Get rights and content

Abstract

Background

Multicystic prostatic tumors are rare, with only a few reported cases of prostatic cystadenoma and cystadenocarcinoma in the scientific literature.

Methods

A retrospective review of our tumor registry over the last 25 years identified 2 rare cystic tumors of the prostate: 1 multilocular cystadenoma and 1 multilocular cystadenocarcinoma.

Results

The first case illustrates the clinical and pathologic features of prostatic multilocular cystadenoma. A 42-year-old man presented with a 16-cm suprapubic mass causing displacement of adjacent visceral organs. Pathologic examination after prostatectomy confirmed it to be a multilocular cystadenoma of the prostate. The patient’s postoperative course was uneventful, and his serum prostate-specific antigen level remained at ≤0.04 ng/ml throughout the course of his disease. In the second case, we present an 80-year-old male presenting with a 12-cm cystic mass of the prostate. His serum prostate-specific antigen level remained at ≥9.0 ng/ml throughout the course of his disease. The tumor had an aggressive local growth pattern, with invasion into perirectal adipose tissue. This patient underwent a pelvic exenteration, followed by adjuvant systemic chemotherapy and complete androgen blockade. Despite aggressive treatment, he had 3 recurrences over 4 months but remains alive with disease at 23-month follow-up.

Conclusions

Cystadenocarcinoma of the prostate is locally aggressive and should be included in the differential diagnosis of cystic lesions of the prostate.

Introduction

Cystic tumors of the female adnexa are common, and much is known about their evaluation and treatment [1]. However, cystic lesions of the male genitalia are extremely rare; only 12 cases of prostatic cystadenoma have been reported in the English literature [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]. To the best of our knowledge, there have been only 15 reported cases of the malignant counterpart of prostatic cystadenoma, termed cystadenocarcinoma [13], [14], [15], [16]. Because of the rarity of prostatic papillary cystadenocarcinoma, there has yet to be established diagnostic histopathologic criteria required to make this diagnosis. As such, the aim of the current study was to highlight the distinguishing clinical and pathologic features differentiating prostatic cystadenoma and cystadenocarcinoma. In addition, a review of the scientific literature on papillary cystadenoma and cystadenocarcinoma addresses the differential diagnosis and treatment options for these conditions.

Section snippets

Study design

After obtaining approval from our institutional review board, we queried our tumor registry for prostate cancer cases (N = 7242) evaluated at the University of Texas M.D. Anderson Cancer Center from January 1, 1980, to December 31, 2004. Of these patients, we reviewed all cystic lesions of the prostate referred and/or treated at our institution during this time. We identified 1 case of a multilocular cystadenoma and 1 multilocular cystadenocarcinoma. The clinical presentation, laboratory, and

Clinical presentation

A previously healthy 42-year-old man presented with obstructive urinary symptoms and with 1 episode of urinary retention. Physical examination and computerized tomography (CT) revealed a 16-cm multicystic pelvic mass with lateral displacement of the urinary bladder (Fig. 1A). His preoperative serum prostate-specific antigen (PSA) level was 0.04 ng/ml. On examination of a biopsy sample, we found fibrous tissue with interspersed prostatic glands having no atypical features. An open prostatectomy

Discussion

In this report, we describe 2 cases of extremely rare cystic lesions of the prostate, with similar cytoarchitectural features but distinct clinical and pathologic characteristics. Both tumors consisted of multilocular cysts, however, their epithelial linings had distinctive features (Table 2). A single layer of cuboidal cells lined the cystic spaces of the cystadenoma, with nuclei presenting no atypia or prominent nucleoli. These cells were phenotypically similar to prostatic acinar columnar

Conclusions

In the present study, we report 2 rare cystic tumors of the prostate, termed multilocular cystadenoma and cystadenocarcinoma. Both these tumors have distinguishing clinical and pathologic features that must be considered when establishing their diagnosis. Furthermore, cystadenocarcinoma of the prostate is a locally aggressive tumor with a propensity for local recurrence, therefore placing much importance on the adequacy of surgical resection, with the role of neoadjuvant and adjuvant therapy

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Original articleMultilocular cystadenoma and cystadenocarcinoma of the prostate

Abstract

Background

Methods

Results

Conclusions

Introduction

Section snippets

Study design

Clinical presentation

Discussion

Conclusions

J Urol

Urology

J Urol

J Urol

Urology

Urology

J Urol

Urology

J Urol

J Urol

Urology

J Urol

J Urol

Eur J Surg Oncol

Pathology of gynecologic malignancies

Semin Surg Oncol

Original article
Multilocular cystadenoma and cystadenocarcinoma of the prostate