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Lesko P, Obertova J, Kajo K, Rejlekova K, Orszaghova Z, Lehotska V, Ondrusova M, Chovanec M, Ondrus D, Mego M. Testicular Seminoma in Prostate: Case Report and Review of Literature. Clin Genitourin Cancer 2024; 22:210-216. [PMID: 38040557 DOI: 10.1016/j.clgc.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Peter Lesko
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Jana Obertova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Karol Kajo
- Department of Pathology, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Katarina Rejlekova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Zuzana Orszaghova
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Viera Lehotska
- 2nd Department of Radiology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Martina Ondrusova
- Department of Preventive and Clinical Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Michal Chovanec
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1st Department of Oncology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Michal Mego
- 2nd Department of Oncology, Comenius University, Faculty of Medicine & National Cancer Institute, Bratislava, Slovak Republic.
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Cao ZL, Lian BJ, Chen WY, Fang XD, Jin HY, Zhang K, Qi XP. Diagnosis and treatment of primary seminoma of the prostate: A case report and review of literature. World J Clin Cases 2023; 11:2267-2275. [PMID: 37122514 PMCID: PMC10131029 DOI: 10.12998/wjcc.v11.i10.2267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Primary seminoma of the prostate (PSP) is a rare type of extragonadal germ cell tumour that is easily misdiagnosed, owing to the lack of specific clinical features. It is therefore necessary for clinicians to work toward improving the accuracy of PSP diagnosis.
CASE SUMMARY A 59-year-old male patient presenting with acute urinary retention was admitted to a local hospital. A misdiagnosis of benign prostatic hyperplasia led to an improper prostatectomy. Histopathology revealed PSP invading the bladder neck and bilateral seminal vesicles. Further radiotherapy treatment for the local lesion was performed, and the patient had a disease-free survival period of 96 mo. This case was analysed along with 13 other cases of PSP identified from the literature. Only four of the cases (28.6%) were initially confirmed by prostate biopsy. In these cases, imaging examinations showed an enlarged prostate (range 6-11 cm) involving the bladder neck (13/14). Of the 14 total cases, 11 (78.6%) presented typical pure seminoma cell features, staining strongly positive for placental alkaline phosphatase, CD117, and OCT4. The median age at diagnosis was 51 (range 27-59) years, and patients had a median progression-free survival time of 48 (range 6-156) mo after treatment by cisplatin-based chemotherapy combined with surgery or radiotherapy. The remaining three were cases of mixed embryonal tumours with focal seminoma, which had clinical features similar to those of pure PSP, in addition that they also had elevated serum alpha-fetoprotein, beta-human chorionic gonadotropin, and lactose dehydrogenase.
CONCLUSION PSP should be considered in patients younger than 60 years with an enlarged prostate invading the bladder neck. Further prostate biopsies may aid in proper PSP diagnosis. Cisplatin-based chemotherapy is still the main primary therapy for PSP.
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Affiliation(s)
- Zhi-Lie Cao
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Bi-Jun Lian
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Wei-Ying Chen
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 318050, Zhejiang Province, China
| | - Xu-Dong Fang
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Hang-Yang Jin
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
| | - Ke Zhang
- Center for Radiation Oncology, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou 310002, Zhejiang Province, China
| | - Xiao-Ping Qi
- Department of Urology, The 903rd PLA Hospital, Hangzhou Medical College, Hangzhou 310004, Zhejiang Province, China
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Akingbade A, Gopaul D, Brastianos HC, Hubay S. Radiotherapy as a Single Modality in Primary Seminoma of the Prostate. Cureus 2021; 13:e14264. [PMID: 33959446 PMCID: PMC8093112 DOI: 10.7759/cureus.14264] [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] [Indexed: 11/29/2022] Open
Abstract
Extragonadal germ cell tumors (EGCTs) are uncommon, and those involving the prostate are rare. We report on a primary seminoma of the prostate in a 56-year-old male presenting with scrotal pain, urinary frequency and urgency, and erectile dysfunction. Digital rectal examination revealed a hard, markedly enlarged prostate projecting posteriorly into the rectum. All 12 cores from ultrasound-guided prostate biopsy revealed malignant cells that stained positive for OCT4, PLAP, and CD117. Imaging revealed a 10.2 cm x 7.8 cm x 8.4 cm prostate mass with irregular nodular margins extending superiorly to the base of the bladder and posteriorly abutting the anterior rectal wall. There was no evidence of distant metastatic disease on both nuclear medicine and CT scans of the chest, abdomen, and pelvis. An 11 mm right internal iliac lymph node and several tiny sub-centimeter external iliac nodes were noted bilaterally. The patient was treated with radiotherapy to the prostate and pelvic lymph nodes. The pelvic lymph nodes were treated with 20 Gy in eight fractions, followed by a boost to the prostate for a further 20 Gy in eight fractions. There was a significant response during treatment that allowed an adaptive boost for a further 10 Gy in four fractions to bring the total dose to the prostate to 50 Gy in 20 fractions. Treatment was well tolerated. Adjuvant chemotherapy was not recommended. He remains disease-free 24 months post-treatment. This case report indicates that like most seminomas, extragonadal seminomas are exquisitely sensitive to radiotherapy and may be considered for the primary treatment of non-metastatic disease. To our knowledge, this is the first reported case of the sole use of radiotherapy to treat a primary seminoma of the prostate.
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Affiliation(s)
| | - Darin Gopaul
- Radiation Oncology, Grand River Regional Cancer Centre, Kitchener, CAN
| | | | - Stacey Hubay
- Medical Oncology, Grand River Regional Cancer Centre, Kitchener, CAN
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Gundavda K, Bakshi G, Prakash G, Menon S, Pal M. The Curious Case of Primary Prostatic Seminoma. Urology 2020; 144:e6-e9. [PMID: 32758494 DOI: 10.1016/j.urology.2020.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Kaival Gundavda
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ganesh Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Atypical Presentation of Seminoma in the Prostate - Case Report. Urology 2019; 132:33-36. [PMID: 31136770 DOI: 10.1016/j.urology.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/28/2019] [Accepted: 05/16/2019] [Indexed: 12/13/2022]
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Torelli T, Lughezzani G, Catanzaro M, Nicolai N, Colecchia M, Biasoni D, Piva L, Maffezzini M, Stagni S, Necchi A, Giannatempo P, Farè E, Salvioni R. Prostatic Metastases from Testicular Nonseminomatous Germ Cell Cancer: Two Case Reports and a Review of the Literature. TUMORI JOURNAL 2018; 99:e203-7. [DOI: 10.1177/030089161309900513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Prostatic metastases from testicular germ cell tumors (TGCTs) are extremely uncommon. To the best of our knowledge, only five cases of prostatic metastases from seminoma have been reported in the literature. Conversely, no cases of metastases to the prostate from nonseminomatous germ cell tumors (NSGCT) have been previously reported. Case presentation We present two patients who developed prostatic metastases 5 and 21 years after the initial diagnosis. The first case concerned a 28-year-old Caucasian man who underwent a right orchiectomy and right retroperitoneal lymph node dissection (RPLND) for a stage I NSGCT in 1999 and five years later was diagnosed with prostatic metastases. The second case concerned a 30-year-old man treated with a right orchiectomy and right RPLND for stage I NSGCT in 1985 who was diagnosed with prostatic metastases in 2006, 21 years after primary surgery. We reviewed the available literature on the topic. Conclusion Prostatic metastases from TCGTs are highly unusual. Lower urinary tract symptoms in patients treated for previous testicular cancer require immediate clinical attention. However, because of their extreme rarity, specific clinical investigations to screen for possible prostatic involvement from TGCT should not be recommended.
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Affiliation(s)
- Tullio Torelli
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Mario Catanzaro
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Nicolai
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maurizio Colecchia
- Department of Pathology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Davide Biasoni
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Piva
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Massimo Maffezzini
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvia Stagni
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Necchi
- Department of Oncology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Elena Farè
- Department of Oncology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Salvioni
- Department of Urology, IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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7
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[Incidental undifferentiated carcinoma of the prostate: A case with unusual diagnosis]. Urologe A 2014; 54:1602-5. [PMID: 25301238 DOI: 10.1007/s00120-014-3650-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 69-year-old man presented with an incidental undifferentiated carcinoma of the prostate. Ten years ago the patient had clinical stage I seminoma of the right testis with adjuvant radiotherapy. Follow-up care was without pathological findings. Staging examinations did not show metastatic disease. After radical prostatectomy with pelvic lymphadenectomy, the histological examination revealed a metastatic seminoma in the prostate. Therefore, the diagnosis was a late relapse in an extremely rare location. So far only four other reports describe testicular seminoma with metastases to the prostate.
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Abstract
Non-epithelial prostatic neoplasms are infrequent and cover a broad array of entities that include both benign and highly aggressive tumours. Because they are very infrequent, there is often limited understanding of them, and the recognition of these entities, when encountered, may pose a diagnostic challenge, owing to histological overlap between them or their rarity. Most lesions in this category are mesenchymal in origin, such as prostatic stromal tumours arising from specialized prostatic stroma, smooth muscle tumours, both benign and malignant, and solitary fibrous tumours. Less commonly occurring tumours include neural, germ cell and melanocytic tumours that may be derived from cells not normally present in the prostate. Some tumours have well-established extraprostatic counterparts and, when encountered, are more commonly extraprostatic/secondary in origin; these include gastrointestinal stromal tumours and most haematopoietic tumours. The majority of tumours are characterized by a spindle cell pattern with significant overlap in morphological features. In this setting, appropriate use of immunohistochemistry and molecular studies are often necessary for accurate diagnosis, prognosis, or prediction for therapy. This review addresses and updates the clinicopathological features of the entire spectrum of non-epithelial tumours with an approach to the histological diagnosis.
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Affiliation(s)
- Gladell P Paner
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Abstract
Primary seminoma of the prostate is extremely rare. We describe a case of a 35-year-old man who presented with difficulty in urinating. Physical findings were unremarkable, but a rectal examination revealed a slightly hardened prostate with a nodule in the right lobe. Blood parameters were normal; however, blood chemistry revealed slightly elevated lactic dehydrogenase, and microscopic hematuria was evident. Serum prostate acid phosphate, carcinoembryonic antigen, and alpha-fetoprotein values were within normal limits. Both computed tomography and magnetic resonance images revealed a large mass in the prostate gland. A prostatic sarcoma or malignant lymphoma was initially suspected. A systemic survey using 18-fluoro-2-deoxyglucose (F-18 FDG) positron emission tomography revealed focal FDG uptake in the prostate gland. A prostatic biopsy of the mass was histologically diagnosed to reveal an extragonadal seminoma.
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Hashimoto T, Ohori M, Sakamoto N, Matsubayashi J, Izumi M, Tachibana M. Primary seminoma of the prostate. Int J Urol 2010; 16:967-70. [PMID: 20002841 DOI: 10.1111/j.1442-2042.2009.02403.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract A 54-year-old gentleman was suspected of having sarcoma of the prostate because of his low serum prostate-specific antigen level (1.9 ng/mL) and an enlarged heterogeneous mass on computed tomography and magnetic resonance imaging scans. Pathological examination of the prostate needle biopsy indicated seminoma, which was confirmed with immunohistochemical staining. There was no evidence of disease in other areas on physical examination or on radiographic tests. Therefore, we diagnosed the case as a primary seminoma of the prostate, which was consequently treated with a total of three courses of bleomycin, etoposide and cisplatin chemotherapy. Complete response was obtained on computed tomography, magnetic resonance imaging and prostate needle re-biopsy. To our knowledge, there have only been five cases of primary seminoma of the prostate reported.
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Alsharif M, Aslan DL, Jessurun J, Gulbahce HE, Pambuccian SE. Cytologic diagnosis of metastatic seminoma to the prostate and urinary bladder: a case report. Diagn Cytopathol 2008; 36:734-8. [PMID: 18773441 DOI: 10.1002/dc.20881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 42-year-old man presented with severe abdominal pain, constipation, and hematuria. The patient had a history of seminoma treated by chemotherapy followed by bilateral orchiectomy and retroperitoneal lymph node dissection 16 years earlier. A computed tomography (CT) scan showed a 8.0 x 6.0 x 5.0 cm mass in the retrovesical space, encompassing the left side of his proximal bladder, the prostate, and the rectum. A urine cytologic specimen showed loosely cohesive cell clusters composed of highly atypical large cells and occasional large, single cells with macronucleoli present in a background of mainly lymphocytes and histiocytes was diagnosed as recurrent seminoma. Prostate biopsies showed extensively necrotic seminoma with accompanying granulomatous reaction. The tumor cells were immunoreactive for c-kit (CD117), placental-like alkaline phosphatase (PLAP), D2-40, and OCT4. To our knowledge, this is the second report on urine cytology of metastatic seminoma.
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Affiliation(s)
- Mariam Alsharif
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota 55455, USA
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12
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Abstract
Many significant benign and malignant nonepithelial tumors and stromal tumor-like lesions arise in the prostate gland. Although such lesions are rare, their recognition by the pathologist is essential because their treatment and prognosis are quite variable. In this review, lesions of the specialized prostatic stroma, that is, lesions that can be seen in the stroma of the prostate but not in that of other organs, except for the phyllodes type of lesions, are discussed. Benign and malignant lesions of the soft tissues that occur in the stroma of other organs and are seen with some frequency in the prostate are also discussed. Few of the rarer soft tissue lesions are mentioned. Lesions and tumors with melanocytic differentiation, hematopoietic derivation, and germ cell tumors are described. It is hoped that this review will serve as a useful reference when encountering some of these lesions, all of which are referenced to their original and subsequent reports. Some non-English language references are also cited to reflect the international recognition of these lesions or to give credit to the author who first described the entity.
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Affiliation(s)
- A Shabaik
- Department of Pathology, University of California, School of Medicine, UCSD Medical Center, San Diego, CA 92103-8720, USA
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13
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Farnham SB, Mason SE, Smith JA. Metastatic testicular seminoma to the prostate. Urology 2005; 66:195. [PMID: 16009406 DOI: 10.1016/j.urology.2005.01.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Revised: 01/09/2005] [Accepted: 01/28/2005] [Indexed: 11/17/2022]
Abstract
Prostatic involvement by seminoma is extremely rare. Four case studies have reported primary seminoma of the prostate. Three previous reports have been published of primary testicular seminoma with metastasis to the prostate. We report a fourth case with 10 years of follow-up and describe the initial management with orchiectomy and platinum-based chemotherapy, local pelvic tumor recurrence, subsequent salvage chemotherapy, and finally cystoprostatectomy with ileal neobladder. The patient was disease free at last follow-up 4 years after surgery.
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Affiliation(s)
- Scott B Farnham
- Department of Urologic Surgery, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765, USA.
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Abstract
Most germ cell tumors occur in the gonads or in extragonadal sites in the anatomic midline; this article reviews tumors with similar or identical histologic features that arise in other topographic locations. Such lesions often represent the presence of "germ cell-like" or "germinal" components in what is otherwise recognized as a somatic neoplasm; however, they may also occur in pure form. The morphologic and immunohistochemical features of these proliferations are reviewed, according to the types of germ cell tumors that they recapitulate.
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Affiliation(s)
- J Carlos Manivel
- Division of Surgical Pathology, Department of Laboratory Medicine & Pathology, University of Minnesota School of Medicine, Minneapolis, MN 55455, USA.
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Han G, Miura K, Takayama T, Tsutsui Y. Primary prostatic endodermal sinus tumor (yolk sac tumor) combined with a small focal seminoma. Am J Surg Pathol 2003; 27:554-9. [PMID: 12657943 DOI: 10.1097/00000478-200304000-00018] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report on a primary endodermal sinus tumor (EST) (yolk sac tumor) combined with a focal seminoma of the prostate occurring in a 24-year-old man. The prostate was widely infiltrated with neoplasms that penetrated the capsule and invaded into the bladder wall and urethra. Most areas of the tumor were composed of papillary and glandular epithelium in the fibrous or myxoid stroma. Schiller-Duval bodies and periodic acid-Schiff-positive hyaline bodies were focally present. In addition to yolk sac tumor, solid nests of seminoma were found in some areas. Immunohistochemistry using specific antibodies for alpha-fetoprotein and cytokeratin showed positive reaction on the EST portion, and placental alkaline phosphatase revealed positive staining in the seminoma portion and a part of EST. Tumor cells exhibited negative staining for prostate-specific antigen, prostatic acid phosphatase, carcinoembryonic antigen, vimentin, chromogranin A, and human chorionic gonadotropin. Despite radical surgery and ordinary cisplatin-based chemotherapy, the patient died 8 months after operation. At autopsy, only EST elements had metastasized to the lungs, liver, and brain, and no tumors were found in either testis. To our knowledge, this is the first reported case of a primary EST combined with a focal seminoma in the prostate.
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Affiliation(s)
- Guiping Han
- Department of Pathology, Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Hamamatsu-shi, 431-3192 Japan
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