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• W2612342341 abstract "Letters to the EditorSo-Called Endometrioid Adenocarcinoma of the Prostate: A Misnomer Jose I. LopezMD Jose I. Lopez Service of Pathology, Bilbao Civil Hospital, 48013 Bilbao, Spain Search for more papers by this author Published Online::1 Sep 1989https://doi.org/10.5144/0256-4947.1989.516SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor: Since the first description of endometrial carcinoma of the prostatic utricle,1 a suggestive hypothesis was made about the histogenesis of some prostatic adenocarcinomas showing endometrioid features. The arrival of an immunohistochemical method as a practical diagnostic tool was the end of this attractive idea. I have recently observed a case of papillary adenocarcinoma arising within the prostate gland closely related with the urethra, and some old and recent questions came to my mind.The patient was a 66-year-old man with urinary retention syndrome and macroscopic hematuria noticed several months before. On cystoscopic examination, an obstructive mass pushing the urethral wall was observed around the verumontanum. Findings on rectal examination were normal. Serum acid phosphatase and other biochemical determinations were within normal limits. Transurethral resection was done, and the patient was symptom-free 1 year later.Histopathologic examination (Figure 1) of the surgical specimen showed a neoplastic growth beneath the urothelium with a prominent papillary pattern. Papillae were composed of tall columnar pseudostratified cells with abundant eosinophilic cytoplasms. Occasionally, a tubular pattern with back-to-back features was observed, mainly at the edge of the tumor. Mild atypia and mitosis were present. Prostatic-specific antigen resulted in a positive cytoplasmic stain.Figure 1. (a) panoramic view illustrating the neoplastic growth beneath the urothelium (arrows) (hematoxylin and eosin, original magnification, × 100). (b) tubulopapillary pattern lined by tall columnar neoplastic cells (hematoxylin and eosin, original magnification, × 100). (b) tubulopapillary pattern lined by tall columnar neoplastic cells (hematoxylin and eosin, original magnification,×400).Download FigureProstatic adenocarcinomas with prominent papillary pattern are infrequent.2 A suggestive hypothesis concerning mullerian origin has been proposed.1,3 This hypothesis was based on the histologic similarities with endometrial carcinoma. Moreover, a typical localization closely related with the utriculum prostaticum—a proved mullerian structure—was claimed as additional proof. On the other hand, some authors4 advocated a prostatic duct origin and supported it with ultra-structural studies. More recently, some ultrastructural studies5,6 confirmed those findings. Since immunohistochemical reports2,5,7,8 identify both prostatic specific antigen and prostatic acid phosphatase in, those tumors—both are not demonstrated in endometrial carcinoma—the controversy seems to have been clarified.In summary, the so-called endometrioid adenocarcinoma of the prostate is a misnomer leading to confusion, and it should be abandoned. Prostatic ducts are the most reasonable origin of this entity, and the papillary pattern must be interpreted as an architectural variant.ARTICLE REFERENCES:1. Melicow MM, Pachter MR. Endometrial carcinoma of prostatic utricle (uterus masculinus) . Cancer. 1967; 20: 1715–22. Google Scholar2. Epstein JI, Woodruff JM. Adenocarcinoma of the prostate with endometrioid features: a light microscopic and immunohistochemical study of ten cases . Cancer. 1986; 57: 111–9. Google Scholar3. Melicow MM, Tannenbaum M. Endometrial carcinoma of the uterus masculinus (prostatic utricle): report of six cases . J Urol. 1971; 106: 892–902. Google Scholar4. Zaluodek C, Williams JW, Kempson RL. Endometrial adenocarcinoma of the prostate: a distinctive tumor of probable prostatic duct origin . Cancer. 1976; 37: 2255–62. Google Scholar5. Bostwick DG, Kindrachuk RW, Rouse RV. Prostatic adenocarcinoma with endometrioid features: clinical, pathologic, and ultrastructural findings . Am J Surg Pathol. 1985; 9: 595–609. Google Scholar6. Srigley JR, Hartwick WJ, Edwards V, DeHarven E. Selected ultrastructural aspects of urothelial and prostatic tumors . Ultrastruct Pathol. 1988; 12: 67–86. Google Scholar7. Nadji M, Tabei SZ, Castro A, et al. Prostatic origin of tumors, an immunohistochemical study . Am J Clin Pathol. 1980; 73: 735–9. Google Scholar8. Walker AN, Mills SE, Fechner RE, Perry JM. Endometrial adenocarcinoma of the prostatic urethra arising in a villous polyp: a light microscopic and immunoperoxidase study . Arch Pathol Lab Med. 1982; 106: 624–7. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 9, Issue 5September 1989 Metrics History Published online1 September 1989 InformationCopyright © 1989, Annals of Saudi MedicinePDF download" @default.
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• W2612342341 title "So-Called Endometrioid Adenocarcinoma of the Prostate: A Misnomer" @default.
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