Sarcoma Of Prostate Research Articles

Painless Gross Hematuria: A New Presentation of Primitive Neuroectodermal Tumor of the Prostate

Introduction: Primitive neuroectodermal tumor (PNET) is a very rare type of prostate sarcoma that mostly occurs in young adults, and it is associated with a poor prognosis. Case Presentation: A 37-year-old male was admitted with intermittent painless gross hematuria from 1 month prior to admission. Cystosocopy, abdominopelvic computed tomography scan (ACTS), and magnetic resonance imaging (MRI) revealed huge prostate. All tumor markers were negative and pathology findings of trans-rectal ultrasonographic biopsy (TRUS Bx) and trans-urethral resection of prostate (TURP) were consistent with severely inflamed prostatic urethra with no evidence of malignancy. The patient underwent radical prostatectomy. Histopathology of the specimens showed malignant neoplasm of small round and oval cells suggestive of PNET. Immunohistochemistry (IHC) study results on CD99 were positive. Conclusions: We report a rare uncommon case of prostate PNET presented by intermittent painless gross hematuria. As the prognosis is very poor, medical staff should pay enough attention to the differential diagnosis, choosing the best treatment and subjects close follow-up.

Evaluation of incidence and histolopathological findings of soft tissue sarcomas in genitourinary tract: Uludag university experience.

ABSTRACTPurpose:In this study we aimed to review urological soft tissue sarcomas of genitourinary tract that were diagnosed in our institution and their prognostic factors for survival.Materials and Methods:The clinical and pathological records of 31 patients who had diagnosis of soft tissue sarcomas primarily originating from the genitourinary tract between 2005-2011 were reviewed.Results:The most common site was kidney (17 cases, 54.8%), and most common diagnosis was leiomyosarcoma (11 cases, 35.4%). A total of 24 patients (77.4%) had surgical excision. The surgical margins were positive in 7 patients who presented with local recurrence after primary resection. Twelve patients developed metastatic disease. During follow-up (range 9-70 month), 26 of the 31 patients (88.9%) were alive. Significant survival differences were found according to histological type (p: 0.001), with lower survival rates for malignant fibrous histiocytoma. The tumor size, the presence of metastasis at the time of diagnosis and tumor localization were not statistically significant for overall survival.Conclusions:In our series, prostate sarcomas, paratesticular rhabdomyosarcoma and malignant fibrous histiocytoma had poor prognosis, especially in patients presenting with metastatic disease.

Demographics, stage distribution, and relative roles of surgery and radiotherapy on survival of persons with primary prostate sarcomas.

BackgroundPrimary prostate sarcomas (PPS) are rare. Outcomes for this cancer have not been well characterized.Materials and MethodsSubjects with a PPS diagnosed between 1973 and 2014 were identified in the SEER database. Subjects were stratified by disease stage and types of therapies received. Disease‐specific survival (DSS) and Overall survival (OS) was estimated by Kaplan‐Meier analysis and cohorts were compared with a univariate and multivariable Cox regression.ResultsThe incidence of PPS among all prostate cancer diagnoses was 0.02%. Subjects younger than age 26 years at diagnosis represented 29% of cases, and 32% of primary prostate sarcomas were rhabdomyosarcoma histology.Rhabdomyosarcoma HistologiesThe median age at diagnosis was 9 years. Between age 0‐25 years rhabdomyosarcoma accounted for 96.4% of primary prostate sarcoma diagnoses, after age 25 rhabdomyosarcoma represented 15% of new diagnoses. The 10‐year DSS and OS for rhabdomyosarcoma was 47% and 44%.Non‐Rhabdomyosarcoma HistologiesThe median age at diagnosis was 71 years. The most common diagnoses were leiomyosarcoma (33%) and carcinosarcoma (28%). Localized, regional, or distant disease occurred in 40%, 34%, and 26% of cases. The 10‐year DSS and OS were 26% and 14%. In locally advanced cases, RT added to surgery trended toward improved DSS (P = 0.10).ConclusionsDisease‐specific survival and OS for non‐rhabdomyosarcoma histologies appear inferior to those of rhabdomyosarcoma. The addition of RT to surgical resection may improve DSS in locally advanced non‐rhabdomyosarcoma. This is the largest report of the incidence, stage distribution, and survival for this extremely rare urologic malignancy providing valuable prognostic information.

Myeloid sarcoma of the prostate: a case report and releated literature review

目的 通过学习前列腺髓系肉瘤探讨其临床特点及诊疗策略等。 方法 回顾性报道1例前列腺髓系肉瘤患者的临床表现、治疗方案和治疗效果，并复习相关文献资料。 结果 患者行DA方案化疗，3个月后患者复查急性粒细胞白血病复发，1年后死亡。 结论 前列腺髓系肉瘤常为急性粒细胞性白血病的局部表现之一，或为其复发的早期症状，需要早期给予急性白血病化疗方案进行化疗，结合局部手术治疗、外周血造血干细胞移植、放疗及靶向治疗等治疗。总体来说，髓系肉瘤预后差。

Whole-exome sequencing demonstrates recurrent somatic copy number alterations and sporadic mutations in specialized stromal tumors of the prostate

In a previous array comparative genomic hybridization study, we detected common deletions of chromosomes 13 and 14 in prostatic stromal sarcoma and stromal tumor of uncertain malignant potential (STUMP). In this study, we performed whole-exome sequencing (WES) and fluorescence in situ hybridization to explore somatic mutations in 1 low-grade stromal sarcoma, 1 high-grade stromal sarcoma, and 12 STUMPs including 5 cases of degenerative atypia type, 1 myxoid type, 1 phyllodes type, and 5 cases of recently described round cell type. WES was successful on 13 cases that revealed frequent somatic copy number alterations including losses of chromosomes 13 (11 cases), 14 (11 cases), and 1p (9 cases), and partial or complete loss of chromosome 10 (7 cases). Fluorescence in situ hybridization was done on 9 cases and showed compatible chromosome 13 copy numbers with the WES results. STUMPs and the low-grade stromal sarcoma carried moderate tumor mutation burdens that ranged from 1.23 to 7.24 mutations per megabase, while the high-grade stromal sarcoma harbored a significantly higher mutation burden (11.55 mutations per megabase). Sporadic somatic mutations were observed, but no recurrent driver mutations could be discerned. In conjunction with prior array comparative genomic hybridization, we have demonstrated the consistent gene dosage profiles that support the clonal nature and the concept of specialized stromal tumors of the prostate as a distinctive tumor entity.

Anti-cancer gold(I) phosphine complexes: Cyclic trimers and tetramers containing the P-Au-P moiety

We report the application of cationic tri- and tetra-nuclear gold(I) phosphine complexes [Au3(μ-dppen)3]X3 and [Au4(μ-dppa)4]X4 (X=OTf, PF6) [OTf=trifluoromethanesulfonate, dppen=trans-1,2-bis(diphenylphosphino)ethene, dppa=bis(diphenylphosphino)acetylene] for cancer treatment. The results of cytotoxicity tests on four different cancer cells [prostate (DU145), cervical (HeLa), breast (MDAMB-231) and fibro sarcoma (HT1080)] indicate these complexes possess remarkable tumor cell growth inhibitory effects and high selectivity towards cancer cells. The anti-tumor mechanism of the tri- and tetra-nuclear gold(I) complexes has also been investigated.

Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study.

Adult prostatic sarcoma (PS) is a rare disease. While surgery is considered the standard approach, the role of other therapies is not completely established. We report results of the largest multicentric contemporary cohort of PS patients. This study included 61 adult PS patients treated in 16 American and European Institutions. Median age was 64.4 years (range: 22-87). Curative surgery was delivered in 48 patients (prostatectomy = 26, cystoprostatectomy = 22), usually with lymphadenectomy (n = 40). Curative radiotherapy (RT) was delivered in 32 patients, as radical (n = 5), neoadjuvant (n = 10), or postoperative treatment (n = 17). Eighteen patients received chemotherapy. None of the patients received hormonal therapy. Median follow-up was 72 months (95%CI: 55-not reached). Five-year local control (LC), overall survival (OS), cancer-specific survival, disease-free survival, and metastases-free rates were 47%, 53%, 56%, 35%, and 35%, respectively. Notably, curative RT (neoadjuvant, adjuvant, or definitive) was associated with improved 5-year LC (55% vs. 31%, P = 0.02) and OS (59% vs. 46%, P = 0.1). Surgically treated patients presenting with a cT3-4 tumor (n = 31), who received RT (n = 24), had a significantly improved 5-year LC (68% vs, 33%, P = 0.004) and OS (65% vs. 21%, P < 0.001) rates compared to patients not receiving RT. cT4 patients demonstrated a significantly lower 5-year OS (43% vs. 61%, P = 0.006) and LC (29% vs. 69%, P < 0.001) rates. Histologic subtype was not associated with LC and OS, but patients with prostatic stromal sarcoma, rhabdomyosarcoma, or sarcomatoid carcinoma had worse 5-year LC compared to other types (47% vs. 55%) and OS (49% vs. 58%). Adult PS has a poor prognosis. Locally advanced tumors have poor LC and OS rates. Curative RT should be considered part of the multidisciplinary approach to PS.

Use of Ultrasonography in Clarifying the Etiology of Anal Pain

IntroductionAnal pain is defined as pain originating from the anal canal or the perianal area that can be attributed to a variety of medical problems. The current study's aim was to evaluate the role of combined endoanal, transperineal, and in married women, transvaginal ultrasound in clarifying the etiology of anal pain among our patient study group. MethodologyA total of 180 patients presented to our radiology department complaining of anal pain and were examined using transperineal, endoanal, and in women, transvaginal ultrasound aided with three-dimensional capability. The final diagnosis was reached, according to the surgical results and the histopathology reports in cases diagnosed with anorectal neoplasms and perianal masses. ResultsA total of 100 patients were diagnosed with perianal fistulas. Twenty-five cases presented with anal abscesses. In four cases, pilonidal sinus extended to the perianal spaces. Three cases had hiradenitis suppurativa, 13 cases showed occult anal sphincter defects, two cases had anorectal neoplasms, and one case was diagnosed with soft tissue ependymoma overlying the coccyx. Three cases were diagnosed with perianal soft tissue masses. One case was detected with recto vaginal fistulas, 10 cases showed thick internal anal sphincter, two cases had perianal cysts, and one case had perianal hematoma. Two cases showed hemorrhage in Douglas' pouch, and one case had pelvic collection sequelae of perforated pelvic appendicitis. Three cases had pelvic endometriosis; one case was detected with missed contraceptive device in the rectum. Three cases were diagnosed with prostatitis and two cases with prostatic abscesses. Two cases had prostatic carcinoma and one case had prostatic sarcoma. ConclusionThe combined approaches of endoanal, transperineal, and in women, transvaginal ultrasound aided with three-dimensional capability proved highly valuable in clarifying the etiology of anal pain in our study group.

Surgical Management of Primary Spindle Cell Sarcoma of Prostate

Primary spindle cell sarcoma of prostate is an extremely rare malignancy and very few cases of it have been reported Ozturk and Sivrikoz, 2013; Hansel and Epstein, 2006. We searched the literature through MEDLINE database using PubMed and Scopus for the articles published between January 1988 and September 2016. Our search was limited to the following keywords: "spindle cell sarcoma," "prostate," and "surgical management." Most of the papers focused on histopathology of the tumor, and very few discussed surgical management. We present a case of localized primary spindle cell sarcoma of the prostate operated at our institute with the difficulties we faced and their management.

Local Staging of Prostate Cancer Using Three Dimensional (3D) Transrectal Ultrasound Assisted with Power Doppler Capability

Introduction: The ability to differentiate between carcinoma confined to the prostate and the extra-capsular extension (ECE) of the tumor is the key point for management. ECE of prostate cancer can lead to failure of radical prostatectomy and every attempt should be made to localize the tumor and assess its extensions preoperatively. The study aimed to evaluate the value of three dimensional (3D) Transrectal ultrasound (TRUS) assisted with power Doppler in local staging of prostate cancer. Methodology: -3D TRUS assisted with the power Doppler capability was performed for 120 patients were complaining of burning urination, difficult urination or blood in urine, among them 95 patients were subjected to 3D TRUS guided biopsies. Results: 33 patients showed prostatic carcinomas, 2 patients showed prostatic sarcoma. In patients with proven prostate cancer 3D TRUS showed an estimated sensitivity 85.7% and specificity 90% with a positive predictive value 83.3%, negative predictive value 91.5% and total accuracy 90.9%. 77% of our cancer patients (27/35) showed hypervascularity by power Doppler ultrasonography while 8 patients (23%) showed no abnormal high vascularity. Power Doppler increased the sensitivity of 3D TRUS in the detection of prostate cancer from 85.7% to 88.5% 3D TRUS clearly identified the extra-prostatic spread in 15 out of 18 patients of an estimated sensitivity (83%). Conclusion: 3D TRUS aided with power Doppler is a valuable tool in local staging of prostate cancer .The expected benefits in local staging of prostate cancer from the combination of 3D TRUS, power Doppler and 3D TRUS guided biopsy as one sitting exam, will be highly promising.

The Economic Burden of Cancer in Spain: A Literature Review

Although cancer is known to impose a huge financial burden, a comprehensive review summarising the information available on the burden of cancer in Spain has not yet been published. The objective of this study was to conduct a descriptive review of the literature on cost of illness studies of cancer in Spain over the past 15 years to better understand the socioeconomic burden of the disease and better allocate resources and research funds. 27 articles were identified relative to healthcare costs attributable to prostate, breast, colorectal, lung, cervical, skin cancer, and soft tissue sarcoma. The majority of studies underestimated total costs, focusing just on direct costs. Additionally, cancer costs vary widely across studies as a result of the lack of a methodological consensus to estimate them. However, despite the variation in the costs reported, this updated literature synthesis demonstrated that cancer represents an important economic burden.

Prostatic leiomyosarcoma: A rare and aggressive tumor

Primary prostatic sarcomas of adults are very rare with the most common type being prostatic leiomyosarcoma. They occur in men in their late age with the clinical features similar to that of prostatic carcinoma, so diagnosis can only be made after the resection of prostate and histopathological examination. Histopathologically, they are mitotically active tumors composed of interlacing fascicles and bundles of smooth muscle with areas of necrosis. These tumors have an aggressive clinical course and bad prognosis. Here, we present a case of 58 years male who presented with urinary complaints and lower abdominal pain. After microscopic and immunohistochemical examination of the specimen following transurethral resection of prostate, a final diagnosis of prostatic leiomyosarcoma was made.

P071 - Primary prostatic sarcomas: A large multidisciplinary Rare Cancer Network study

P071 - Primary prostatic sarcomas: A large multidisciplinary Rare Cancer Network study

Metastatic Prostatic Stromal Sarcoma: A Challenging Diagnosis on Fine Needle Aspiration with Broad Differential Diagnosis

Metastatic Prostatic Stromal Sarcoma: A Challenging Diagnosis on Fine Needle Aspiration with Broad Differential Diagnosis

The Prevalence of Prostatic Stromal Tumor of Uncertain Malignant Potential in Specimens Diagnosed as Prostatic Hyperplasia.

Prostatic stromal tumors of uncertain malignant potential (STUMPs) are rare tumors arising from the specialized prostatic stroma. These tumors share certain histological and clinical features of benign prostatic hyperplasia, resulting in misdiagnosis of STUMP as prostatic hyperplasia. However, in contrast to prostatic hyperplasia, occasional cases have been documented to recur rapidly after resection and few of them have progressed to prostatic stromal sarcoma and distant metastasis. In this study, we aimed to estimate the prevalence of prostatic STUMP in specimens initially diagnosed as prostatic hyperplasia. A total of 702 consecutive pathology slides with a diagnosis of prostatic hyperplasia between 2009 to 2014 in specimens were obtained by prostatectomy or trans- urethral resection of the prostate. Those slides were submitted to Faghihi hospital, affiliated to Shiraz University of Medical Sciences, and were reviewed retrospectively in order to search the findings in favor of STUMP. Based on histological findings, STUMP was identified in 3 cases (0.43%), which revealed hypercellular stroma, infiltrating between the hyperplastic glands. Cells showed some degree of pleomorphism, nuclei with vesicular chromatin and few mitotic figures. No recurrence was reported in patients. Although STUMP can be histologically and clinically misdiagnosed as BPH, the differences in prognosis and treatment modalities highlight the importance of rendering the correct diagnosis.

JAK-STAT signaling in cancer: From cytokines to non-coding genome

In the past decades, studies of the Janus kinases (JAKs) and signal transducers and activators of transcription (STATs) signaling have uncovered highly conserved programs linking cytokine signaling to the regulation of essential cellular mechanisms such as proliferation, invasion, survival, inflammation and immunity. Inhibitors of the JAK/STAT pathway are used for treatment of autoimmune diseases, such as rheumatoid arthritis or psoriasis. Aberrant JAK/STAT signaling has been identified to contribute to cancer progression and metastatic development. Targeting of JAK/STAT pathway is currently one of the most promising therapeutic strategies in prostate cancer (PCa), hematopoietic malignancies and sarcomas. Notably, newly identified regulators of JAK/STAT signaling, the non-coding RNAs transcripts and their role as important targets and potential clinical biomarkers are highlighted in this review. In addition to the established role of the JAK/STAT signaling pathway in traditional cytokine signaling the non-coding RNAs add yet another layer of hidden regulation and function.Understanding the crosstalk of non-coding RNA with JAK/STAT signaling in cancer is of critical importance and may result in better patient stratification not only in terms of prognosis but also in the context of therapy.

Beyond Prostate Adenocarcinoma: Expanding the Differential Diagnosis in Prostate Pathologic Conditions.

Recent advances in magnetic resonance (MR) imaging of the prostate gland have dramatically improved the ability to detect and stage adenocarcinoma of the prostate, one of the most frequently diagnosed cancers in men and one of the most frequently diagnosed pathologic conditions of the prostate gland. A wide variety of nonadenocarcinoma diseases can also be seen with MR imaging, ranging from benign to malignant diseases, as well as infectious and inflammatory manifestations. Many of these diseases have distinctive imaging features that allow differentiation from prostate acinar adenocarcinoma. Early recognition of these entities produces a more accurate differential diagnosis and may enable more expeditious clinical workup. Benign neoplasms of the prostate include plexiform neurofibroma and cystadenoma, both of which demonstrate distinctive imaging features. Stromal neoplasms of uncertain malignant potential are rare tumors of uncertain malignant potential that are often difficult to distinguish at imaging from more-malignant prostate sarcomas. Other malignant neoplasms of the prostate include urothelial carcinoma, primary prostatic carcinoid, carcinosarcoma, endometrioid or ductal adenocarcinoma, and mucinous adenocarcinoma. Prostatic infections can lead to abscesses of pyogenic, tuberculous, or fungal origins. Finally, miscellaneous idiopathic disorders of the prostate include amyloidosis, exophytic benign prostatic hyperplasia, and various congenital cysts. Considerable overlap can exist in the clinical history and imaging findings associated with these prostate pathologic conditions, and biopsy is often required for ultimate confirmation of the diagnosis. However, many diagnoses, including cystadenoma, mucinous adenocarcinoma, sarcoma, and abscesses, have distinct imaging features, which can enable the informed radiologist to identify the diagnosis and recommend appropriate clinical workup and management. (©)RSNA, 2016.

Within the next five years, adaptive hypofractionation will become the most common form of radiotherapy.

Within the next five years, adaptive hypofractionation will become the most common form of radiotherapy.

Long term follow-up of surgery management of prostate leiomyosarcoma metastasized to the rib: A case report and literature review.

Prostate sarcoma, particularly the pathological type of leiomyosarcoma, is a rare carcinoma, which originated from the interstitial tissue of the prostate. This sarcoma type has a poor prognosis. This disease accounts for ~0.1% of all prostate cancer and it usually occurrs in patients aged between 40 and 78-years-old. Although prostate leiomyosarcoma has a poor prognosis, early treatment of post-operative recurrence and metastases via a whole-body examination and closer follow-up was possible. These measurements may significantly prolong the survival time and improve the quality of life. The present study reported a successful case of surgical management for prostate leiomyosarcoma in the Zigong No. 4 People's Hospital (Sichuan, China) during 1995 until 2015, with post-operative follow-up for 20 years.

The utility of STAT6 and ALDH1 expression in the differential diagnosis of solitary fibrous tumor versus prostate-specific stromal neoplasms

Solitary fibrous tumor (SFT) diagnosis in prostate can be challenging on small biopsies. Prostatic stromal tumors of unknown malignant potential (STUMP) and SFT have overlapping features. NAB2-STAT6 gene fusions that were recently identified in various SFTs lead to nuclear translocalization of STAT6. Nuclear STAT6 immunostaining is now considered an adjunct for SFT diagnosis. We evaluated STAT6 and an emerging stemness marker, ALDH1, in the differential diagnosis of SFT versus prostatic stromal lesions. Sixteen STUMPs, 12 SFTs, and 4 prostatic stromal sarcomas (12 needle biopsies, 13 radical prostatectomies, 7 transurethral resections) were retrieved (1995-2015). Sections were stained with polyclonal STAT6 antibody (Santa Cruz Biotechnology, Santa Cruz, CA; S20, 1:100) and monoclonal ALDH1 antibody (BD Biosciences, San Jose, CA; clone 44, 1:250). In STAT6 cases, only unequivocal nuclear staining (with/without cytoplasmic staining) was considered positive. Cytoplasmic ALDH1 staining was counted positive. Ten of 11 evaluable SFTs demonstrated strong and diffuse nuclear STAT6 positivity; 4 of 16 STUMPs had nuclear staining that was weak (1/4) or focal (1/4). ALDH1 positivity was seen in 10 of 12 evaluable SFTs and 3 of 15 STUMPs. Prostatic stromal sarcomas were STAT6 negative (4/4); 2 of 4 were ALDH1 positive. The sensitivity and specificity for STAT6 for the diagnosis of SFT were 91% and 75%, respectively. Coexpression of STAT6 and ALDH1 yielded the same sensitivity but improved the specificity (100%) for the diagnosis of SFT. STAT6 is a useful marker in the differential diagnosis of SFT versus STUMP. Using STAT6 and ALDH1 together increases specificity. STUMPs can show STAT6 positivity, and when they do, it is likely to be weak or focal.