前列腺基底细胞癌一例报告并文献复习

目的探讨前列腺基底细胞癌的临床特点及其诊治方法。方法分析1例前列腺基底细胞癌患者的临床资料,并结合文献对前列腺基底细胞癌的临床病理特征、诊断治疗及预后进行分析。结果肿瘤位于前列腺左侧叶,切面实性,灰白色。组织学检查：癌细胞排列成实性团块状或筛网状,瘤细胞体积较小,细胞核大并呈卵圆形,大小一致,胞浆少,可见核分裂象。肿瘤呈浸润性生长,肿瘤边缘部分见前列腺基底细胞增生,病理诊断为前列腺基底细胞癌。肿瘤组织中前列腺基底细胞特异抗体（34E12）、p53和p63基因阳性表达,PAP、PSA和S100蛋白阴性表达。术后患者恢复良好,无尿失禁及血尿。随访27个月未见肿瘤复发及转移。结论前列腺基底细胞癌是一种罕见的前列腺恶性肿瘤,虽然具有惰性生物学行为,但常与前列腺腺癌伴发,且肿瘤有侵袭和转移的潜能,根治性前列腺切除术应作为治疗的第一选择。

A case report of basal cell carcinoma of prostate and review literature

Objective To elucidate both the clinical characteristics and the diagnosis and treatment of basal cell carcinoma of prostate.Methods A case of basal cell carcinoma of the prostate was reported,and the relevant literature was reviewed to investigate the clinicopathological features,diagnosis and treatment,prognosis of this disease.A 65-year-old male patient suffered from progressive dysuria,intermittent gross hematuria for 2 year, who had Ⅱ°hyperplastic and hard prostate,and the left lobe of the prostate had a nodule about 0.5cm in diameter.The PSA was 3.6 ng/mL.The prostatic needle biopsy result showed basal cell carcinoma of the prostate（left lobe）.The patient underwent retropubic radical prostatectomy.Results Grossly,the tumor was located in the left lobe of the prostate,and the sectioned surface of the tumor was solid and grey.Microscopically,the tumor cell was small in volume with ovoid karyomegaly and caryokinesis was seen.Some of the cells arranged like solid nest,sieve-like or cribriform appearance,the tumors displayed invasive growth.Proliferated basilar cells of the prostate were found in marginal part of the tumor.The pathological diagnosis was basal cell carcinoma of the prostate.Immunohistochemical results showed 34 E12（＋）,p53（＋） and p63（＋）;PAP（-）,PSA（-） and S100（-）.Postoperatively, the patient recovered well without urinary incontinence or hematuria.During a follow-up of 27 months,the tumor had no recurrence and metastasis.Conclusion Basal cell carcinoma of prostate is a rare subtype of prostate cancer,which shows an indolent course.For the frequently coexistence of basal cell carcinoma and adenocarcinoma of prostate,and the local infiltrative and distant metastatic potentiality,radical surgery is the preferred first-line management option.