Diagnosis and treatment of primary seminoma of the prostate:A case report and review of literature  

作　　者：Zhi-Lie Cao Bi-Jun Lian Wei-Ying Chen Xu-Dong Fang Hang-Yang Jin Ke Zhang Xiao-Ping Qi 

机构地区：[1]Department of Urology,The 903^(rd)PLA Hospital,Hangzhou Medical College,Hangzhou 310004,Zhejiang Province,China [2]Department of Urology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Enze Hospital,Taizhou Enze Medical Center(Group),Taizhou 318050,Zhejiang Province,China [3]Center for Radiation Oncology,Affiliated Hangzhou Cancer Hospital,Zhejiang University School of Medicine,Hangzhou 310002,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第10期2267-2275,共9页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81472861;The Key Project of Zhejiang Province Science and Technology Plan,China,No.2014C03048-1;Hangzhou Municipal Commission of Health and Family Planning Science and Technology Program,No.B20210355.

摘　　要：BACKGROUND Primary seminoma of the prostate(PSP)is a rare type of extragonadal germ cell tumour that is easily misdiagnosed,owing to the lack of specific clinical features.It is therefore necessary for clinicians to work toward improving the accuracy of PSP diagnosis.CASE SUMMARY A 59-year-old male patient presenting with acute urinary retention was admitted to a local hospital.A misdiagnosis of benign prostatic hyperplasia led to an improper prostatectomy.Histopathology revealed PSP invading the bladder neck and bilateral seminal vesicles.Further radiotherapy treatment for the local lesion was performed,and the patient had a disease-free survival period of 96 mo.This case was analysed along with 13 other cases of PSP identified from the literature.Only four of the cases(28.6%)were initially confirmed by prostate biopsy.In these cases,imaging examinations showed an enlarged prostate(range 6-11 cm)involving the bladder neck(13/14).Of the 14 total cases,11(78.6%)presented typical pure seminoma cell features,staining strongly positive for placental alkaline phosphatase,CD117,and OCT4.The median age at diagnosis was 51(range 27-59)years,and patients had a median progression-free survival time of 48(range 6-156)mo after treatment by cisplatin-based chemotherapy combined with surgery or radiotherapy.The remaining three were cases of mixed embryonal tumours with focal seminoma,which had clinical features similar to those of pure PSP,in addition that they also had elevated serum alpha fetoprotein,beta-human chorionic gonadotropin,and lactose dehydrogenase.CONCLUSION PSP should be considered in patients younger than 60 years with an enlarged prostate invading the bladder neck.Further prostate biopsies may aid in proper PSP diagnosis.Cisplatin-based chemotherapy is still the main primary therapy for PSP.

关 键 词：Prostatic neoplasms SEMINOMA Germ cell and embryonic neoplasms Diagnosis Case report 

分 类 号：R737.25[医药卫生—肿瘤]