前列腺基底细胞癌一例报告及文献复习

Basaloma of the prostate gland(a case report and review of the literature)

目的提高对前列腺基底细胞癌诊断及治疗的认识。方法报告1例前列腺基底细胞癌患者诊治结果,结合文献复习,探讨本病的组织发生及诊治特点。67岁男性,间歇性肉眼血尿3年,前列腺Ⅱ度增生,右叶明显抬高,质地较硬。PSA 5 ng/ml。前列腺穿刺活检报告：前列腺腺样基底细胞肿瘤,低度恶性。术前口服氟他胺治疗45 d,行前列腺根治性切除术。结果病理报告：肿瘤有完整包膜,肿块呈分叶状,瘤细胞体积小,细胞核大并呈卵圆形、大小一致,核分裂相少见,部分细胞呈实性巢状或梁状排列,部分筛孔样结构。浸润性生长,边缘部分见前列腺腺体基底细胞增生。病理诊断为前列腺基底细胞样癌(腺样囊性癌)。患者术后恢复良好,无尿失禁,血尿消失。随访24个月无复发。结论腺样基底细胞癌/腺样囊性癌为前列腺腺癌的一个亚型,临床罕见,恶性程度低,生长缓慢,转移较晚,外科手术治疗效果较好,预后较好。

Objective To improve the recognition in the diagnosis and treatment of basaloma of the prostate gland. Methods A case of basaloma of the prostate gland was reported, and. the relevant literature was reviewed to investigate the histogenesis,diagnosis and treatment of this disease. A 67-year-old male patient suffered from intermittent gross hematuria for 3 years. He had Ⅱ° hyperplastie prostate gland, and the right lobe of the prostate was elevated obviously in hard texture. The PSA level was 5 ng/ml. The prostate biopsy result showed glandule-like basaloma of the prostate gland with low potential malignancy. After chemotherapy with of Flutamine for 45 d,the patient underwent radical prostatectnmy. Results Postoperative pathology showed that the tumor had intact capsule and was lobulated. The tumor cell was small in volume with ovoid karyomegaly and seldom caryokinesis. Some of the cells arranged like fruit nest,and infiltratively grew. Proliferated basilar cells of the prostate were found in marginal part of the tumor. The pathological diagnosis was basaloma （adenoid cystic carcinoma） of the prostate gland. Postoperatively, the patient recovered well with no urinary incontinence or hematuria. During a follow-up of 2 years, the patient had no recurrence. Conclusions Adenoid basal cell carcinoma/adenoid cystic carcinoma is a clinically rare subtype of adenoid carcinoma of the prostate with low PSA level,low potential malignancy, slow growth,late metastasis and better prognosis. Radical prostatectomy is recommended for this disease.