前立腺類内膜腺癌の1例

Abstract

60歳男.前立腺肥大症であり, PSAの上昇を指摘された.MRI検査で前立腺部尿道近傍に分葉状の辺縁を有し, T2強調画像で高信号を呈し, 内部に低信号を有する腫瘤を認めた.超音波検査で前立腺より膀胱内に突出する, high echoicとlow echoicとが混在した腫瘤を認めた.経直腸的及び経会陰的前立腺針生検を施行し, 前立腺類内膜腺癌が疑われた.リンパ節転移, 骨転移はなく, stage B2の診断で恥骨後式前立腺全摘除術を施行した.病理組織所見で腫瘍は尿道近傍にのみ存在し, 嚢胞状に拡張した腫瘍腺管内で著明な乳頭状増殖を示しており, あたかも内膜癌の形態を示していた.腫瘍の存在部位, 組織形態から前立腺類内膜腺癌Gleason's score 3+4, pT2bpN0M0と診断した.現在術後6ヵ月を経過するが, 再発徴候は認められていない

We report a case of endometrioid adenocarcinoma of the prostate. A 60-year-old man visited our hospital with high serum prostate specific antigen (PSA) level (6.4 ng/ml). Digital rectal examination revealed prostatic enlargement but no induration was palpable. Magnetic resonance imaging (MRI) of the prostate demonstrated the low intensity mass lesion around the prostatic urethra on T2-weighted images. Because a prostate cancer revealed by transrectal and transperineal needle biopsy of the prostate, retropubic radical prostatectomy was performed and histological finding showed endometrioid adenocarcinoma of the prostate. We review 41 cases reported in the Japanese literature and discuss them briefly.