RESUMEN
El carcinoma de próstata es el tumor maligno más prevalente en el varón. La glándula prostática normal está constituida por 3 tipos celulares: el luminal o secretor, el basal y el neuroendocrino. Las células neuroendocrinas se distribuyen en toda la extensión de la glándula prostática, con mayor frecuencia en los conductos que en el tejido acinar. La diferenciación neuroendocrina es un hallazgo frecuente en los carcinomas prostáticos, en su mayoría de modo focal, y en los casos en que la diferenciación es extensa, se asocia con refractariedad a la terapia hormonal o enfermedad agresiva. Describimos un caso de un carcinoma de próstata poco diferenciado de células pequeñas con diferenciación neuroendocrina con componente minoritario de adenocarcinoma convencional, resaltando el hallazgo del tumor primario mediante el diagnóstico de una metástasis ganglionar de carcinoma neuroendocrino de células grandes (AU)
Prostate carcinoma is the most common malignant tumour in men. The normal prostate gland is composed of three cell types: luminal, basal and neuroendocrine. Neuro-endocrine cells are found throughout the prostate gland, although are more frequent in ducts than in the acinar tissue. Neuroendocrine differentiation is often seen in prostatic carcinomas, usually focally, but, when differentiation is extensive, it is associated with failed hormonal therapy or aggressive disease. We describe a case of a poorly differentiated small cell prostate carcinoma with neuroendocrine differentiation that had a small component of conventional adenocarcinoma. Thus, a nodal metastasis of large cell neuroendocrine carcinoma led to the diagnosis of the primary tumour (AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/patología , Carcinoma/patología , Carcinoma Neuroendocrino/complicaciones , Carcinoma Neuroendocrino/patología , Carcinoma de Células Pequeñas/patología , Diagnóstico Diferencial , Carcinoma Neuroendocrino/diagnóstico , Carcinoma Neuroendocrino/fisiopatología , Carcinoma de Células Pequeñas/complicaciones , Carcinoma de Células Pequeñas/fisiopatología , Hipertensión/complicaciones , Inmunohistoquímica/métodos , InmunohistoquímicaRESUMEN
BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common primary mesenchymal neoplasia in the gastrointestinal tract, although they represent only a small fraction of total gastrointestinal malignancies in adults (<2%). GISTs can be located at any level of the gastrointestinal tract; the stomach is the most common location (60-70%), in contrast to the rectum, which is most rare (4%). When a GIST invades into the adjacent prostate tissue, it can simulate prostate cancer. In this study, we report on a case comprising the unexpected collision between a rectal GIST tumour and a prostatic adenocarcinoma. FINDINGS: We describe the complexity of the clinical, endoscopic and radiological diagnosis, of the differential diagnosis based on tumour biopsy, and of the role of neoadjuvant therapy using imatinib prior to surgical treatment. CONCLUSIONS: Although isolated cases of coexisting GISTs and prostatic adenocarcinomas have previously been described, this is the first reported case in the medical literature of a collision tumour involving a rectal GIST and prostatic adenocarcinoma components. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1238437468776331.