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• W2066057013 abstract "No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Sep 2004PHYLLODES TUMOR OF THE PROSTATE: LONG-TERM FOLLOWUP STUDY OF 23 CASES DAVID G. BOSTWICK, DELOAR HOSSAIN, JUNQI QIAN, ROXANN M. NEUMANN, PING YANG, ROBERT H. YOUNG, P. ANTHONY DI SANT’AGNESE, and EDWARD C. JONES DAVID G. BOSTWICKDAVID G. BOSTWICK Financial interest and/or other relationship with Bostwick Laboratories, AstraZeneca, Genotherapeutics, Diagnocure, Photocure, GlaxoSmithKline, Medlon and Endocare. More articles by this author , DELOAR HOSSAINDELOAR HOSSAIN More articles by this author , JUNQI QIANJUNQI QIAN More articles by this author , ROXANN M. NEUMANNROXANN M. NEUMANN More articles by this author , PING YANGPING YANG More articles by this author , ROBERT H. YOUNGROBERT H. YOUNG More articles by this author , P. ANTHONY DI SANT’AGNESEP. ANTHONY DI SANT’AGNESE More articles by this author , and EDWARD C. JONESEDWARD C. JONES More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000134580.71261.57AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Phyllodes tumor of the prostate is a rare neoplasm of uncertain malignant potential. We studied a large series of phyllodes tumors to define the combination of histological features that are most useful for predicting patient outcome. Materials and Methods: A total of 23 cases were obtained from our collective files from 1973 to 2002, and numerous clinical and pathological features were evaluated. A review of the reported cases of phyllodes tumor of the prostate was done. Results: Patient age was 25 to 86 years (mean 55) and they usually presented with urinary obstructive symptoms and hematuria. The diagnosis was made in 18 tumors by transurethral resection, in 2 by enucleation, in 1 by tumor resection and in 2 by prostatectomy. We analyzed 5 histological features, including cellularity (scale of 1 to 3), cytologic atypia (scale of 1 to 3), the number of mitotic figures per 10 high power fields, the stroma-to-epithelium ratio (low or high) and necrosis (present or absent). This combination of features revealed that 14 cases were low grade phyllodes tumor, 7 were intermediate grade and 2 were high grade with the high grade cases characterized by increased cellularity, severe cytological atypia, more than 5 mitotic figures per 10 high power fields and a high stroma-to-epithelium ratio, indicating stromal overgrowth. Immunohistochemical studies of 8 tumors revealed consistent, intense cytoplasmic immunoreactivity in stromal cells for vimentin and actin, in luminal epithelial cells for prostate specific antigen, prostatic acid phosphatase and broad-spectrum keratin AE1/AE3, and in basal cells for high molecular weight keratin 34β-E12. Recurrence was seen in 7 of 14 low grade tumors (50%) and in 1 patient low grade sarcoma emerged with subsequent distant metastases 14 years after initial diagnosis following 5 recurrences. Recurrence was seen in 6 of 7 intermediate grade tumors and low grade sarcoma emerged with subsequent abdominal wall metastases in 1 patient 11 years after initial diagnosis following 3 recurrences. The phyllodes tumor recurred in each patient with high grade tumors with a time to first recurrence of 6 and 0.2 years, respectively. Distant metastases developed in these 2 patients. Conclusions: Histological grading of prostatic phyllodes tumors is predictive of short-term outcome based on the combination of stromal cellularity, cytological atypia, number of mitotic figures and the stroma-to-epithelium ratio. However, these tumors usually recur after transurethral prostatic resection and they are often locally aggressive with time. The emergence of overt sarcoma and metastatic disease is more frequent than previously recognized. Complete resection at initial diagnosis appears to be indicated. References 1 : Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinico-pathologic study of 22 cases. Am J Surg Pathol1998; 22: 148. Google Scholar 2 : Malignant phyllodes tumor of the prostate: retrospective review of specimens obtained by sequential transurethral resection. Pathol Int2002; 52: 777. Google Scholar 3 : Prostatic phyllodes tumor, a rare entity. Anatamo-clinical and immunohistochemical study of 1 case. Ann Pathol2000; 20: 629. Google Scholar 4 : Cystosarcoma phyllodes of the prostate with rhabdomyoblastic differentiation. Pathol Res Pract2001; 197: 657. Google Scholar 5 : Giant cystosarcoma phyllodes of the prostate associated with adenocarcinoma. Arch Pathol Lab Med1992; 116: 195. Google Scholar 6 : Malignant phyllodes tumor of the prostate. Pathol Int1999; 49: 1105. Google Scholar 7 : Chemotherapy induced complete remission in malignant phyllodes tumor of the prostate metastasizing to the lung. J Urol2002; 168: 1104. Link, Google Scholar 8 : Malignant phyllodes tumor of prostate. Urology1990; 35: 164. Google Scholar 9 : Phyllodes tumor of the prostate. A case report and review of the literature. Eur Urol2000; 38: 649. Google Scholar 10 : Phyllodes type of atypical prostatic hyperplasia. J Urol1999; 162: 803. Link, Google Scholar 11 : Malignant phyllodes tumor of the prostate. Int J Urol2000; 7: 378. Google Scholar 12 : Malignant phyllodes tumor of the prostate. A case report with immunohistochemical and ultrastructural studies. Arch Pathol Lab Med1992; 116: 296. Google Scholar 13 : Leiomyosarcoma arising in atypical fibromuscular hyperplasia (phyllodes tumor) of the prostate with distant metastasis. Cancer1991; 68: 910. Google Scholar 14 : Prostatic cystic epithelial-stromal tumors: a report of 2 new cases. J Urol1993; 149: 860. Link, Google Scholar 15 : Phyllodes tumor of the prostate: a case report. Jpn J Clin Oncol1989; 19: 299. Google Scholar 16 : Prostatic stromal hyperplasia with atypia: a study of 11 cases. J Urol Pathol1997; 6: 15. Google Scholar 17 : Leiomyosarcoma of the prostate. Report of 23 cases. Cancer1995; 76: 1422. Google Scholar 18 : Carcinosarcoma of the prostate. Report of 21 cases. Cancer1995; 76: 1035. Google Scholar 19 : Cystosarcoma phyllodes of the seminal vesicle. Cancer1993; 71: 2055. Google Scholar 20 : Phyllodes tumor in a male patient with bilateral gynaecomastia induced by oestrogen therapy for prostatic carcinoma. Eur J Surg Oncol1991; 17: 215. Google Scholar From the Bostwick Laboratories (DGB, JQ), Richmond, Virginia, Department of Pathology, Health Sciences Center, University of Manitoba (DH), Winnipeg, Manitoba and Department of Pathology, Vancouver General Hospital (ECJ), Vancouver, British Columbia, Canada, Department of Urology (RMN) and Division of Epidemiology (PY), Mayo Clinic, Rochester, Minnesota, Department of Pathology, Massachusetts General Hospital and Harvard Medical School (RHY), Boston, Massachusetts, and Department of Pathology, University of Rochester Medical Center (PAdS’A), Rochester, New York© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySauder K and MacLennan G (2018) PHYLLODES TUMOR OF THE PROSTATEJournal of Urology, VOL. 174, NO. 6, (2373-2373), Online publication date: 1-Dec-2005. Volume 172Issue 3September 2004Page: 894-899 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsfibroadenomaprostatesarcomaphyllodes tumoradenosarcomaMetricsAuthor Information DAVID G. BOSTWICK Financial interest and/or other relationship with Bostwick Laboratories, AstraZeneca, Genotherapeutics, Diagnocure, Photocure, GlaxoSmithKline, Medlon and Endocare. More articles by this author DELOAR HOSSAIN More articles by this author JUNQI QIAN More articles by this author ROXANN M. NEUMANN More articles by this author PING YANG More articles by this author ROBERT H. YOUNG More articles by this author P. ANTHONY DI SANT’AGNESE More articles by this author EDWARD C. JONES More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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