Prostatic stromal sarcoma with neuroectodermal differentiation

Hitoshi Yamazaki,Teppei Ohyama,Toshiki Tsuboi,Hiroyoshi Iguchi,Yoshinori Taoka,Teruaki Ao,Dai Kohguchi

doi:10.1186/1746-1596-7-173

Hitoshi Yamazaki, Teppei Ohyama + Show 5 more

Open Access

https://doi.org/10.1186/1746-1596-7-173

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Journal: Diagnostic Pathology	Publication Date: Dec 1, 2012
Citations: 33	License type: CC BY 2.0

Affiliation: Kitasato University Medical Center

Abstract

Prostatic stromal sarcoma is a fairly rare tumor that constitutes approximately 0.1–0.2% of all prostatic cancers. Detailed characteristics of the tumor are still unclear due to its rarity.We describe a case of prostatic stromal sarcoma in a 63 year-old man who suffered from urinary obstructive symptoms. Palliative transuterine resection was performed and the preliminary histopathological diagnosis was neuroendocrine carcinoma. After chemotherapy, total pelvic exenteration was performed. Histopathologically, the tumor was composed of monotonously proliferating small to medium-sized round cells, which existed in compact islands with loose or dense fibrovascular networks. Immunohistochemically, the tumor cells were widely positive for vimentin, CD56, CD99 and focally positive for synaptophysin, CD10, progesterone receptor, desmin and CD34, but negative for EMA, cytokeratin, estrogen receptor, S-100 and myoglobin. Most of the previously reported tumors exhibited positive stainability for CD10 and progesterone receptor. In addition to these markers, expressions of CD56, CD99 and synaptophysin were characteristically detected in our case. To the best of our knowledge, we present the first case of prostatic stromal sarcoma with characteristic immunohistochemical staining properties. Although the biological characteristics of this rare tumor have not yet been elucidated, these findings suggest prostatic stromal sarcoma can potentially show neuroectodermal differentiation.Virtual slideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7291874028051262

Highlights

Prostatic stromal sarcoma (PSS) is a fairly rare tumor, constituting approximately 0.1% of all prostatic cancers [1,2]
The tumor cells were positive for vimentin, CD56, synaptophysin but negative for EMA, cytokeratin, S-100
The tumor cells were widely positive for vimentin, CD56, CD99 and focally positive for synaptophysin, CD10, progesterone receptor, desmin and CD34, but negative for EMA, cytokeratin, estrogen receptor, S-100, GFAP and myoglobin (Figure 3b,c,d)

Summary

Background

Prostatic stromal sarcoma (PSS) is a fairly rare tumor, constituting approximately 0.1% of all prostatic cancers [1,2]. Case presentation The patient was a 63 year-old man who presented to the urologist with a one week history of dysuria, pollakiuria and an unrelieved feeling after urination. He had a previous history of diabetes mellitus and asymptomatic multiple brain infarction. Computed tomography revealed a prostatic mass lesion which protruded into the bladder space (Figure 1a). Serial sections were analyzed and revealed a round cell sarcomatous tumor with occasional higher cellularity than that in the previous transuterine resection. The tumor cells were widely positive for vimentin, CD56, CD99 and focally positive for synaptophysin, CD10, progesterone receptor, desmin and CD34, but negative for EMA, cytokeratin, estrogen receptor, S-100, GFAP and myoglobin (Figure 3b,c,d). The patient is alive without local recurrence or distant metastasis

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