含5种不同组织学结构的前列腺癌1例报道并文献复习  

Prostate cancer with five different histological features:A case report and review of the literature

作　　者：陈靖[1] 权昌益[2] 畅继武[1] 杨宇明[1] 李博[1] 常文亮[1] 王江[1] 牛远杰[1] 

机构地区：[1]天津医科大学,天津市泌尿外科研究所,天津300211 [2]天津医科大学第二医院泌尿外科,天津300211

出　　处：《中华男科学杂志》2011年第9期825-828,共4页National Journal of Andrology

摘　　要：目的:探讨含有5种不同组织学结构的前列腺癌的临床表现、病理特征、治疗方法。方法:报告1例含有5种组织学结构的前列腺癌的临床资料,并结合文献对其诊断、病理、治疗等进一步分析。结果:患者直肠指检、B超、CT、MRI及PSA均提示前列腺癌,行穿刺活检后确诊。考虑患者全身状况行硬膜外麻醉下经尿道前列腺电切术以改善排尿症状。术中切除可疑肿瘤组织,术后病理:前列腺腺癌(筛状癌、腺泡癌、浸润癌、导管癌、黏液腺癌)。Gleason分级9分。术后应用比卡鲁胺和醋酸戈舍瑞林治疗,术后10个月开始出现全身转移,术后1年死亡。结论:含有5种不同组织学结构的前列腺癌极其罕见,难于早期诊断,确诊主要依靠病理和免疫组化检查。Objective： To study the clinical manifestations,pathological characteristics and treatment methods of prostate cancer with five different histological features.Methods： We reported 1 case of prostate cancer with five different histological features and further analyzed the diagnosis,pathology and treatment of the disease by reviewing the relevant literature.Results： The patient was an 84-year-old male,admitted due to difficult urination and dribbling urine for 1 year,hematuria for 8 months and deterioration for 2 weeks.Prostate cancer was indicated by rectal examination,ultrasonography,CT,MRI and PSA,and confirmed by biopsy.Considering the general condition of the patient,we performed electrotransurethral resection under epidural anesthesia to alleviate his urinary symptoms and remove suspected tumor tissues.Postoperative pathology showed the case to be prostate adenocarcinoma,histologically characterized by cribriform carcinoma,acinar carcinoma,diffuse invasive carcinoma,ductal carcinoma,and mucinous adenocarcinoma,with a Gleason score of 9.Bicalutamide and goserelin were administered postoperatively.Systemic metastasis occurred 10 months later,and the patient died 1 year after the operation.Conclusion： Prostate cancer with five different histological features is extremely rare.Its early diagnosis is difficult and mainly depends on pathological and immunohistochemical examinations,and radical prostatectomy can be considered for its treatment.

关 键 词：前列腺癌 黏液腺癌 病理诊断 

分 类 号：R737.25[医药卫生—肿瘤]