A case of giant prostatic cystadenoma

An 80-year-old man was admitted to our hospital with the chief complaint of urinary retention. On physical examination, a large tumor was recognized in pelvic cavity. Serum levels of prostatic acid phosphatase and gamma-seminoprotein were elevated. Anterior pelvic exenteration was performed because the tumor was huge and malignancy could not be ruled out preoperatively. The tumor weight was 660 g (11 x 8 x 7 cm) and had a multicystic structure macroscopically. Immunohistochemical study by the prostatic specific antigen stain showed positive staining in the epithelial cells of the tumor, which suggest that the tumor was of prostatic origin.     

Multilocular prostatic cystadenoma with high-grade prostatic intraepithelial neoplasia

Multilocular prostatic cystadenoma is a rarely encountered neoplasm located in the midline between the bladder and rectum that is either attached to the prostate by a pedicle or separate from the prostate entirely. Histologically and immunohistochemically these lesions resemble benign prostate tissue. We report the first case of this entity for which multifocal high-grade prostatic intraepithelial neoplasia (PIN) is identified. Conceptually, the finding of high-grade PIN in multilocular prostatic cystadenomas provides further evidence that these lesions are fully analogous to the prostate gland not only in their morphology and immunohistochemistry but also in their predilection for the same diseases.     

肝内胆管囊腺瘤一例

正肝内胆管囊腺瘤(intrahepatic biliary cystadenoma,IBC)是一种罕见的胆管上皮源性囊性肿瘤,发病率不足肝脏全部囊性肿瘤的5%~([1-2])。其缺乏典型临床表现,易与肝内其他囊性病变相混淆而误诊。现报道1例IBC并复习相关文献,以提高对该病的认识。病例患者女性,32岁,因"间断性上腹部隐痛不适3周"入院。既往体健,无肝炎肝硬化、血吸虫病史。     

腹腔镜巨大前列腺囊腺瘤切除一例报告并文献复习

目的提高对巨大前列腺囊腺瘤的认识。方法回顾性分析收治的1例巨大前列腺囊腺瘤并成功进行腹腔镜切除的临床资料,结合文献复习进行讨论。结果本例患者成功行腹腔镜完整切除,手术时间125min,出血量60ml,术中双侧精囊输精管完整保留,术后会阴部坠胀不适消失,复查精液常规精子数目及活动度正常。已随诊12个月,肿瘤无复发。结论巨大前列腺囊腺瘤罕见,最终确诊要依靠病理诊断,其最有效的治疗是手术完整切除,而腹腔镜途径可作为完整切除的微创手段。     

重新审视前列腺囊腺瘤的临床病理

目的 探讨前列腺囊腺瘤的临床病理学特点,提高对该病的诊断及治疗水平.方法 回顾性分析1例病理诊断为前列腺囊腺瘤患者的主要症状,诊治情况,结合文献对该病的临床表现、诊断、病理学特征、治疗及预后进行讨论.结果 患者男性,51岁,2008年无明显诱因出现尿频、尿急、排尿困难症状,曾诊断“前列腺炎”,行药物治疗.2012年6月上述症状加重,行彩超检查提示:前列腺肥大并腺体内实性占位;行前列腺穿刺提示:前列腺增生,PINⅡ-Ⅲ级.于外院行TURP治疗,恢复良好.术后1个月开始反复出现血尿.2012年12月7日,急诊以“血尿待查”收入院.入院后完善CT、MRI、膀胱镜等相关检查,诊断为“膀胱颈部占位病变”行经尿道诊断性电切术,将肿物彻底切除.术后病理:前列腺囊腺瘤.组织学特点:前列腺腺体增生,间质纤维组织增生、充血,无细胞异形性,无核分裂像.免疫组化:PSA(+),PSAP(+).结论 前列腺囊腺瘤是一种少见的前列腺来源的良性肿瘤,前列腺囊腺瘤在形态学上具有独特的组织结构,多表达PSA和PSAP.     

A case of papillary cystadenoma of the epididymis

A 74-year-old man who consulted our hospital complaining of painless left scrotal swelling. Computed tomographic demonstrated a left epididymal tumor in the hydrocele. We performed left high orchiectomy. Microscopically, several microcysts were found and tumor cells showing a papillary growth pattern were found in these microcysts. We finally diagnosed the patient as having papillary cystadenoma of the epididymis. Papillary cystadenoma of the epididymis is rare epididymal benign tumor. To our knowledge, 19 cases have been reported in Japan between 1976 and 2000. It is clinically important to determine whether or not the tumor is associated with von Hippel-Lindau disease. In our case, there was no evidence of von Hippel-Lindau disease and the patient has remained well with no complication to date.     

A case of prostatic leiomyosarcoma

A case of a 19-year-old male with leiomyosarcoma of the prostate is reported. He visited our hospital with the chief complaint of urinary retention in December, 1983. Following overall examination, needle biopsy of the prostate gland was performed with the suspicion of sarcoma. Histology of the prostate revealed leiomyosarcoma. Two courses of combined chemotherapy were given, but the tumor continued to enlarge. The patient died in April, 1984, 5 months after the appearance of the first symptom.     

A case of prostatic abscess

A 53-year-old man presented with high fever and urinary retention. The patient had diabetes, and alcoholic liver cirrhosis. Clinical diagnosis was prostatic abscess by magnetic resonance imaging (MRI), and we performed anti-biotic therapy. Because there was no improvement of symptoms, we performed percutaneous cystostomy and transurethral resection (TUR) of the abscess walls. Drainage by TUR is suggested to be a useful strategy for prostatic abscess.     

A case of prostatic hemangiopericytoma

One case of prostatic hemangiopericytoma is reported. The patient was a 38-year-old man who visited us complaining of difficulty in urination for 6 months duration. Before he came to us, he had undergone open prostatectomy under the suspicion of prostatic abscess++ at a previous hospital with failure because of very severe adhesion. He was referred to us under the histologic suspicion of prostatic sarcoma. From the histopathological study, he was finally diagnosed as having hemangiopericytoma. However, it was difficult to diagnose whether the lesion was benign or malignant in nature. After the external X-ray irradiation, he has been placed under our observation for these 20 years with roentgenographic followup. No infiltration or metastasis has been detected. Judging from these findings and our review of the literature, we concluded that the prostatic hemangiopericytoma reported here is benign in nature. To our knowledge, only 6 cases (5 cases from Europe and the US, and 1 case from Japan) have been reported heretofore.     

A case of retroperitoneal mucinous cystadenoma of borderline malignancy

Surgical experience of a rare case of malignant retroperitoneal cyst is reported. A 41-year-old female was admitted on Feb. 26, 1986, complaining of left lower abdominal tumor and mild abdominal pain. She underwent complete removal of an abdominal tumor located at the left flank lateral to the sigmoid colon on March 5. The tumor was well encapsulated, cystic and oval, 12 X 10 X 9 cm in size. Histologic feature of the tumor is classified as mucinous cystadenoma of low grade malignancy by WHO classification.     

A case of papillary cystadenoma of the epididymis]

We report a case of papillary cystadenoma of the left epididymis in a 37-year-old single man. He visited our clinic complaining of painless tumor in the left scrotum. The physical and radiological examinations showed no signs of von Hippel-Lindau syndrome. Surgical exploration revealed a 15 x 15 x 10 mm tumor on the head of the left epididymis. Histopathological examination suggested efferent duct ectasia with papillary formation, with cuboidal epithelium, which was finally diagnosed as papillary cystadenoma of the epididymis. This is the 16th case of papillary cystadenoma of epididymis in Japan.     

A case of giant prostatic hypertrophy

This report deals with a case of an 82-year-old male with a giant prostate that weighted 270 grams. Retropubic prostatectomy was performed successfully. The removed prostate adenoma consisted of adenomatous hyperplasia on pathology. Though the nomenclature of "giant prostatic hypertrophy" is not clear, we reviewed cases of over 200 grams of hypertrophy so far reported in Japan were as giant prostatic hypertrophy. Twenty two cases of giant prostatic hypertrophy have been reported in the Japanese literature to date and our case was the sixth heaviest ever reported in Japan.     

A case of prostatic malignant lymphoma

A 65-year-old man was admitted for dysuria. He had been irradiated 60Co for malignant lymphoma of tonsils 2 years earlier. The findings of palpation of prostate, retrograde urethrogram and urethroscopy strongly suggested benign prostatic hypertrophy. Retropubic prostatectomy was performed and 18 g of "adenoma" was resected. By histological observation, the "adenoma" proved to be malignant lymphoma. This tumor belonged to follicular lymphoma, medium-sized cell type of LSG non-Hodgkin's lymphoma classification. After the operation, he left our hospital for a personal reason and received systemic chemotherapy at another hospital.