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Solitary fibrous tumors (SFTs) usually occur in the pleura and account for two-thirds of all cases; however, SFTs occurring in the prostate are extremely rare. Approximately 25 cases have been reported in the literature to date. This study reports the case of a 43-year-old man referred to our hospital with the chief complaint of a pelvic tumor after careful examination. The tumor marker levels were within normal limits. T2-weighted magnetic resonance imaging revealed a tumor, demonstrating primarily low signal intensity. It showed a capsule-like rim at the left lobe of the prostate, suggesting that the tumor was partially invading the rectal wall. Histopathological examination of needle-core biopsies showed spindle cell neoplasm with small and fusiform cells, strongly expressing signal transducer and activator of transcription 6 (STAT6) with a ramifying vascular network. Therefore, the clinical diagnosis of the patient was SFT of the prostate and robot-assisted radical prostatectomy was performed. Histopathological examination revealed that the tumor was composed of spindle cells with patternless and staghorn patterns. Immunohistochemical analysis showed a strong expression of STAT6. Furthermore, the tumor was partially positive for CD34. Therefore, the patient was diagnosed with SFT of the prostate. Two years after the initial diagnosis, the patient was alive with normal erectile function, continence status, and no evidence of the disease.

Background The giant multilocular prostatic cystadenoma is a very rare benign tumor of the prostate gland. It is composed of predominantly cystic enlarged prostatic glands in a fibrous stroma and spreads extensively into the pelvis. Because of the large size at the time of diagnosis, it is not always possible to determine the exact point of origin for these multilocular cystic neoplasms. Thus, diagnosis before histological examination of a surgical specimen is often difficult. Here, we present a case involving one of the largest giant multilocular prostatic cystadenomas reported in the literature and discuss preoperative diagnoses and appropriate surgical approaches for this rare retroperitoneal tumor. Case presentation A 50-year-old man presented with a 2-year history of abdominal distension and lower urinary symptoms. Enhanced CT showed a large retroperitoneal mass with multiple septations in the pelvis and lower abdomen, measuring 30 cm in size, surrounding the rectum and displacing the bladder, prostate, and seminal vesicle to the right anterior side. MRI showed multiple cysts with a simple fluid appearance on T2-weighted images and enhanced solid components on gadolinium-enhanced fat-saturated T1-weighted images, suggesting the retroperitoneal mass as leiomyoma with cystic degeneration or perivascular epithelioid cell tumor. Biopsy of the mass showed a spindle cell tumor with focal smooth muscle differentiation. Differential diagnosis comprising leiomyoma, low-grade leiomyosarcoma, and perivascular epithelioid cell tumor was made. Complete resection of the tumor with low anterior resection of the rectum was performed. The tumor was solid with multilocular cavities containing blackish-brown fluid and measured 33 × 23 × 10 cm. Histologically, the tumor was composed of variously sized dilated glandular structures lined by prostatic epithelia surrounded by fibromuscular stroma. The prostatic nature of the lesions was confirmed by immunohistochemical staining of the epithelium for prostate-specific antigen. Thus, pathological diagnosis was a giant multilocular prostatic cystadenoma. Conclusions We present our experiences with one of the largest giant multilocular prostatic cystadenomas. When a retroperitoneal huge lesion with locular cavities fills the pelvis in a male patient, the possibility of giant multilocular prostatic cystadenoma should be considered before planning for retroperitoneal tumor treatment.

PURPOSE OF REVIEW Over the past decades, several efforts have been made for integrating multiparametric MRI (mpMRI) in the diagnostic pathways of prostate cancer. Despite this fact, the role of mpMRI in planning surgery has been explored in a relatively small number of studies. The aim of this review is to summarize the current evidence with respect to imaging and specifically mpMRI in planning robot-assisted radical prostatectomy. RECENT FINDINGS Novel tools integrating mpMRI and clinical data have been described for planning surgery. mpMRI results in adds value to models based on clinical parameters only. Three-dimensional printed models of the prostate and prostatic tumor may help in planning surgery, however only few studies with limited number of patients are currently available in this regard. Finally, the integration of mpMRI renderings in the robotic console may help in surgical planning and might increase the diffusion of imaging for planning (and performing) surgery. SUMMARY Imaging in planning surgery is still underutilized. Thus, further studies are needed to increase the use of mpMRI in planning surgery and also in performing surgery.

Among available methods, supercritical fluid (SCF) technology is a new and suitable approach for producing nano-sized particles. For this purpose, determination of a solid solute solubility such as pharmaceutical materials is an essential step. The present research is the first to measure Tamsulosin (TML) solubility in supercritical carbon dioxide (SC-CO2) under operating conditions of 308 to 338 K and 12 to 27 MPa. The mole fraction of TML ranged from 0.18 × 10−6 to 1.013 × 10−5. Experimental data have been modeled with two main models groups; the first group consisted of semi-empirical and empirical models (e.g., Chrastil; Sodeifian et al.; Kumar & Johnston (K-J); Mendez-Santiago & Teja (MST); Bian et al.; Bartle et al.) and the second group have been SAFT-VR (statistical associating fluid theory of variable range) and Peng-Robinson (PR) equations of state. Furthermore, self-consistency test of the experimental data was performed on the solubility data. Finally, the approximate values Δ H t o t a l , Δ H v a p and Δ H s o l enthalpies have been computed.

Although the secondary involvement of the seminal vesicles by prostate cancer is relatively common, seminal vesicle as a primary site for neoplastic disease is uncommon.1 There are a wide variety of tumors among primary seminal vesicle tumors that are derived from both the epithelium and stroma. Hence, they have been classified as mixed epithelial-stromal tumors. This report describes a 32-year-old man who presented with a retrovesical cystic mass that was initially thought to be a prostatic tumor but demonstrated pathologically to be a cystadenoma of the seminal vesicles.

OBJECTIVE: Prostate cancer is one of the common malignant tumors in men worldwide. Nowadays it seems that Gleason Score 3+3 may not need definite treatment and some of the experts even ignore it as a cancer but we should be aware that in some patients with Gleason Score 3+3 there is a higher risk for harboring higher-grade cancer. We had done this study to evaluate patients with prostate cancer with Gleason Score 3+3 to determine the value of tumor volume in these cases. MATERIAL AND METHODS: From September 2010 to October 2017, radical prostatectomy was done for 123 sequential patients with localized prostate cancer in two referral centers of Shahid Beheshti Medical University, Tehran, Iran, and 42 cases with Gleason Scores 3+3 which who were candidates for active surveillance were included in the study. RESULTS: Thirty of 42 (71.4%) patients had significant tumor volumes (≥0/5 cm(3)). When tumor volume was less than 0.5 cm(3), none of the patients had extra prostatic tumor extension. In patients with tumor volume greater than 0.5 cm(3), two cases (6.6%) had extra prostatic extension, 4 cases (13.3%) had positive margins, four cases (13.3%) reactive lymph nodes and 16 cases (53.3%) perineural invasion. CONCLUSION: We suggest that some patients with Gleason Score 3+3 have tumor volume >0.5 cm(3) who are considered having significant cancer pathology and active surveillance may not be appropriate approach to manage all cases with Gleason Score 3+3.

Prostatic cancer represents an important health problem worldwide, being the third most common malignancy in men older than 55 years, after pulmonary and colon cancer. In early stages prostatic cancer remains hard to be diagnosed at clinical or imagistical studies, the most efficient way to detect it being based on the determination of tumor markers. This is a literature review of the largest studies conducted on the theme of prostatic tumor markers.

The diagnostic and therapeutic approach to prostatic neurosarcoma, currently known as a malignant peripheral nerve sheath tumor (MPNst) of the prostate, due to its rarity, is not well established. Our presenting case was a 73 year old patient, admitted to the Hospital with suspicion of a prostatic tumor. The patient underwent surgical resection of the described pathological mass. Gross appearance of the pathological examination revealed a yellow-gray colored tumor, 12 × 6 × 7 cm in size. On cross-section: tumor heterogeneity, fatty, yellow-gray, with no foci of necrosis, but with a few cysts of 1–3 cm in size, with a gelatinous substance. Microscopic examination — showed neurosarcoma of the prostate. The patient died at six months follow-up, due to cardiovascular insufficiency.

BACKGROUND To assess the feasibility, toxicity, and outcome of prostate hemi-irradiation with a high-dose-rate brachytherapy (HDR-BT) boost for patients presumed to harbor dominant intra-prostatic tumors in a single lobe. METHODS After 3D conformal external radiotherapy (3DCRT) to 64–64.4 Gy, 77 patients with non-metastatic locally aggressive prostate cancer have been treated from 2000 to 2004, with HDR-BT using temporary open MRI-guided 192Ir implants, to escalate the dose in the boost region. Twenty patients (26%) had one lobe involvement (i.e., one sided endorectal MRI, rectal examination, and biopsies) and were boosted to one side of the gland only. A dose of 12, 14, and 16 Gy in two fractions was delivered to 5, 6, and 9 patients, respectively. RESULTS After a median follow-up 69 months, no differences in late rectal toxicity were observed between the unilaterally and bilaterally irradiated cohorts. Although, grade 2 late urinary toxicity was worse in the hemi-irradiated group (P = 0.03), severe grade ≥3 late urinary toxicity at 5 years was not different: 10% versus 8.8% in the unilaterally and bilaterally irradiated cohorts, respectively. Grade 4 late urinary toxicity, however, was exclusively observed in patients boosted to both lobes (5/57, 8.8%). Five-year biochemical relapse-free survival was 79.7% versus 70.5% for the unilateral and bilateral boost groups, respectively (P = 0.99). CONCLUSION Prostate hemi-irradiation with a HDR-BT boost to the dominant tumor region may be considered when rectal examination, MRI, and biopsies suggest one lobe involvement. Nevertheless, strict dosimetric optimization is needed in order to further reduce the risk of late severe toxicity. Prostate 71:1309–1316, 2011. © 2011 Wiley-Liss, Inc.

Alveolar rhabdomyosarcoma (RMS) is 1 of 2 main subtypes of RMS in the pediatric age group and tends to occur in the extremities. The urogenital tract is another common site for RMS, but this typically involves the embryonal subtype including sarcoma botryoides. We report a 28-year-old male with a prostatic tumor that was excised en bloc and showed a RMS with separate areas of embryonal and solid alveolar morphologies at the light microscopic level. Both areas showed diffuse nuclear expression for myogenin, and both areas expressed the PAX3-FKHR fusion gene, a genetic change associated with alveolar but not embryonal RMS. A review of the literature documented only 5 cases of RMS primary to the prostate showing alveolar or mixed histology. Ours is the 6th case and the 1st with molecular findings. Although the diagnostic category of mixed embryonal/alveolar RMS remains in use, the nature of this type of RMS is incompletely understood. In our case, although the morphology was mixed embryonal/alveolar, at the genetic level this tumor was alveolar in nature.

The aim of this study was to investigate the potential prognostic value of preoperative serum prostate-specific antigen levels adjusted for total tumor volume (PSA-TTV density) for outcome following radical prostatectomy for prostate cancer by retrospective review in 268 patients. Lower PSA-TTV density was not only associated with a significantly higher risk for biological failure (bF), systemic failure and cancer death but also an independent predictor for bF (hazard ratio, 6.3). Therefore, these data suggest that there are subsets of prostate cancer with lower PSA secretion levels, and this phenotype is associated with a higher risk of failure after surgery.

We report a case of gastrointestinal stromal tumor (GIST) arising from the rectum which mimicked prostatic tumor on computed tomography (CT) and magnetic resonance imaging (MRI). Most GISTs arise in the stomach and/or small intestine; GISTs of anorectal origin are rare. We identify characteristic CT and MRI findings of anorectal GISTs and discuss the diagnostic pitfalls.

We have investigated the photoactivating effect of hypericin on two cancer cell lines: PC-3, a prostatic adenocarcinoma non-responsive to androgen therapy and LNCaP, a lymphonodal metastasis of prostate carcinoma responsive to androgen therapy. The two cell lines are incubated for 24 h with hypericin at concentrations ranging from 0.001 to 0.3 microg/ml in cell culture medium. The cells are irradiated at 599 nm (fluence = 11 J/cm2) using a dye laser pumped by an argon laser. Hypericin exerts phototoxic effects on both cell lines, while it does not produce toxic effects in the absence of irradiation. These results suggest that photodynamic therapy (PDT) with hypericin could be an alternative approach to the treatment of prostatic tumors, and could be beneficial in tumors that are non-responsive to androgen therapy.

Background: A significant proportion of patients will be found to have extracapsular disease and/or detectable prostate specific antigen (PSA) values after radical prostatectomy. The role of postoperative radiotherapy to the prostatic tumor bed remains controversial. Methods: Ninety patients were treated at the Joint Center for Radiation Therapy after radical prostatectomy. The medium dose to prostatic fossa was 64.0 Gy. Medium follow-up was 28.9 months (from time of prostatectomy). Failure after radiotherapy is defined as a persistently detectable PSA level or the development of a detectable PSA level after radiotherapy. None of the patients received androgen ablative therapy until documented postradiotherapy failure. Presurgical PSA levels, Gleason score, pathological findings at surgery, and preradiotherapy PSA levels were analyzed as predictors of PSA failure. Results: A presurgical PSA of >20.0 ng/ml is associated with PSA failure after radiotherapy (p = 0.0239). Preoperative Gleason score, PSA at time of radiotherapy or pathological findings at surgery do not predict for subsequent PSA failure. Conclusion: Postprostatectomy radiotherapy to the prostatic fossa is unlikely to provide long-term PSA-defined, disease-free survival for patients who undergo prostatectomy with a presurgical PSA of >20 ng/ml. Regardless of findings at surgery, these patients have a high rate of developing PSA failure.

In an earlier issue of The Urologic Clinics of North America (volume 20, number 4, 1993) on prostatic tumor markers, we discussed a variety of issues that were involved in the assessment of prostate-specific antigen (PSA) immunoassays. 31 These included the various forms of PSA, molecular heterogeneity, free and complexed PSA, the generation of antibodies to PSA, the need for standardization of PSA assays, criteria for assessing PSA assay performance, heterophile antibodies to PSA that may perturb current PSA assay results, and ultrasensitive PSA assays. Many of the discussions in that article remain relatively current, and updates are not warranted. There are four specific areas, however, in which substantial progress has been made, and new information is now available, and we therefore focus our attention in this update on PSA assay standardization, free and complexed PSA, PSA epitope mapping, and hK2, the twin of PSA.

In this study we compared visual and automated analyses of interphase in situ hybridization (ISH) signals in five prostatic tumor specimens and one normal prostate sample, both in tissue sections and nuclear suspensions. The advantage of tissue sections is preservation of tissue morphology allowing precise analysis of tumor cells only. The advantage of nuclear suspensions is easier access to automated analysis, due to their disaggregated and dispersed cellular appearance. The samples were hybridized with probes for the (peri)centromeric regions of chromosome 1 and Y. The number of ISH signals per nucleus was counted both manually and automatically by means of a commercially available image analysis system. After image analysis the results were interactively corrected using a gallery display. The automatic and manual counts, before and after interactive correction, were then statistically evaluated. We found no significant differences in overall distributions between the automated and the manual counts, before as well as after correction. This was observed for both tissue sections and cellular suspensions. It is therefore concluded that automated analysis of ISH signals is feasible in both nuclear suspensions and in tissue sections, despite a low percentage of nuclei that could be measured on the latter.

Transrectal prostatic tumor thermal ablation with High Intensity Focused Ultrasound (HIFU) is an alternative treatment of prostate cancer in non surgical patients. Material and Methods From November 2001 and October 2003, 116 patients (89 with localized prostatic cancer and 27 re-treatments after surgery, radiotherapy or HIFU) were treated with transrectal HIFU at 3 MHz and 5 sec lesions (Ablatherm,) in our department. All patients were deemed unfit for or refused surgery. In 6 patients < 70 years old with a single positive prostatic biopsy, we used a nerve sparing strategy trying to save the neurovascular bundle of the non affected lobe. The procedure was always performed in spinal anaesthesia and combined with a TURP. Urethral catheter was always removed within 24 hours. A suprapubic tube was left for a longer period. The treatment was planned under ultrasound guidance and computer driven. Results 49 patients reached a follow-up of 12 months. Median P.S.A. nadir was 0.1 ng/mL. At 12 months of follow-up prostatic biopsy were negative in 100% (5/5) low risk patients (LRP), 82.6% (19/23) intermediate risk patients (IRP) and 71.4% (15/21) high risk patients (HRP). 5 HRP with positive biopsy at 6 months were treated again with HIFU. 6 patients treated after anastomotic recurrency post RRP reached a follow up of 6 months: all biopses at 6 months were negative and mean PSA was 0,46 ng/mL. 8 patients with recurrency after external bean radiotherapy got local control of disease in 75% of cases with PSA ≤ 0,5ng/mL in 37.5% of cases. Conclusions HIFU is a feasible alternative treatment of localized prostate cancer in non surgical cases. It is well tolerated by the patients with a short hospital stay and acceptable side effects and does not contraindicate any other local treatment in case of failure.

MR imaging with a body coil is unreliable in directly demonstrating tumor spread through the prostatic capsule. However, the likelihood of extracapsular spread of prostatic cancer rises with increasing tumor volume. The aim of our study was to assess the accuracy of MR with a body coil in diagnosing capsular penetration indirectly via an estimation of prostatic tumor volumes. Twenty-six patients with proved prostatic cancer that was clinically confined to the gland underwent MR imaging before radical prostatectomy and whole-mount pathologic sectioning of the specimen. Twenty of 31 lesions prospectively outlined on the MR images corresponded to cancers outlined on the pathology slides, and tumor volumes were calculated by using a voxel summation technique. On MR, tumor volume was underestimated in 11 of 20 cases and overestimated in nine of 20 cases. Only two of 20 size estimates based on MR findings were within 10% of actual tumor volume. Overlap in MR tumor volumes was significant between lesions with and without capsular penetration at microscopy. Factors contributing to inaccuracies in measurements of tumor volume on MR images included the variable histologic make-up of the tumors. Our results show that, although knowledge of the size of a prostatic lesion is important in predicting the behavior of the tumor, MR imaging with a body coil is not reliable for accurate estimation of tumor volume.

A 56-year-old man initially presented to a local urologist with severe lower urinary tract symptoms and microhematuria. He had a history of hypertension, hyperlipidemia, mild asthma, gastroesophageal reflux disease, erectile dysfunction, and pyeloplasty as a child. Investigations at this time included urinalysis, measurement of serum PSA levels, cystoscopy, urine cytology, and renal ultrasonography. The findings were suggestive of benign prostatic hyperplasia, and the patient received finasteride, tamsulosin, and underwent transurethral needle ablation of the prostate. Four years after the initial presentation, the patient presented to a tertiary institution with worsened symptoms.Upon re-presentation, investigations included measurement of serum PSA levels, pelvic CT, transrectal ultrasound-guided prostate biopsy, histological examination of the biopsy specimen and immunohistochemical staining.Gastrointestinal stromal tumor.Imatinib 400 mg daily followed by surgical resection.

Prostate carcinoma, when metastatic, typically involves bone and produces both osteoblastic and osteolytic changes. Orbital involvement is uncommon and extraocular muscle enlargement is a rare presentation of metastatic prostate adenocarcinoma. The authors present 2 patients with prostatic tumor metastasis to extraocular muscles. One patient had single-muscle involvement; the other presented with bilateral progressive proptosis, upper eyelid retraction, and bilateral multiple extraocular muscle enlargement mimicking thyroid-associated orbitopathy. Clinicians should be aware that, although rare, prostate cancer can involve the extraocular muscles.

The correlation between tumor volume of untreated tumor-bearing nude mice and serum concentration of prostatic acid phosphatase (PAP/RIA) was studied in the hormone-dependent serially transplantable human prostatic tumor models PC-82 and PC-EW. The normal serum level of PAP in control male nude mice without tumor was found to be 0.9 +/- 0.3 ng/ml. Elevated PAP serum concentrations were never found in animals without tumor (a highly specific diagnostic technique). A close correlation was observed between the concentration of PAP in the serum (range 0.3 to 154 ng/ml) and the tumor volume (range 10.0 to 6,530 mm3) of 104 untreated mice bearing a PC-82 or PC-EW human prostatic tumor. This correlation was comparable in both tumor lines (p less than 0.001). The positive effect of endocrine manipulation which resulted in tumor diameter decrease or growth arrest with regressive histological patterns, showed the normal PAP serum level, too. After successful treatment PAP was found to be normal, independent from the residual tumor mass. By contrast, in the event of only retarded tumor growth, the PAP level still correlated with the tumor burden.

Akin to the situation in humans, dogs are frequently affected by tumors of the prostate. The malignancies share many similarities between both species, for example, median age at the onset of the disease and metastatic behavior. In human prostatic tumor samples, investigations of prepared metaphase spreads showed a variety of chromosomal aberrations, with trisomies of chromosomes 7, 8, and 17 as the leading cytogenetic abnormalities. In this article we present one case of a canine adenocarcinoma of the prostate, including clinical examination and establishment of a cell line from a tumor sample obtained from the affected 10-year-old male Briard. Searching for similarities between both species in respect to chromosomal changes within the tumor samples, we investigated prepared metaphases of the canine cell line cytogenetically. These investigations presented a highly rearranged karyotype showing a large biarmed marker consisting of material from chromosomes 1 and 2 in addition to centromeric fusions between dog chromosomes 1 and 5 that both could be identified in every metaphase investigated, while centric fusions of chromosomes 4 and 5 occurred in up to 50% of the metaphases. The cell line grew very well and showed evidence of being spontaneously immortalized when it crossed the 20th passage.

The HMGA architectural nuclear factors are involved in chromatin dynamics and their overexpression has been strongly linked to the neoplastic transformation process. Here we investigate the expression and post-translational modifications (PTMs) of HMGA proteins (HMGA1a, HMGA1b and HMGA2) in the rat prostatic cancer Dunning model (G, AT-1, and MAT-Ly-Lu cell lines). We demonstrate the expression of HMGA2, in addition to HMGA1a and HMGA1b, in both the anaplastic cell lines AT-1 and MAT-Ly-Lu and an extremely specific HMGA1a mono-methylation only in the most metastatic cell line MAT-Ly-Lu. The HMGA ectopic expression in HMGA-negative Dunning G cells does not significantly alter their growth ability, suggesting that, although HMGA expression is necessary for the progression of neoplastic transformation in several cellular models, in these cells it is not sufficient. These data suggest exploring HMGA2 as a potential marker in human prostate tumor and moreover indicate PTMs as an additional tool in the staging of tumor progression.

Secondary prostatic neoplasms are usually the result of direct invasion by neighboring organs or infiltration from hematological malignancies. Gastric adenocarcinoma metastasizing in the prostate is extremely rare and to our knowledge only seven cases have been documented in the literature. We report another case of a patient who underwent transurethral resection of the prostate for bladder outflow obstruction which incidentally revealed an occult metastatic adenocarcinoma from an undiagnosed gastric cancer.

Prostatic neoplasms are rare in childhood. We report a case of primary prostatic carcinoid in a 7-year-old boy who was subsequently diagnosed with multiple endocrine neoplasia IIb. To our knowledge this is the first report of either pediatric carcinoid of the prostate or of prostatic carcinoid in conjunction with neuronal intestinal dysplasia and medullary thyroid carcinoma suggestive of multiple endocrine neoplasia IIb. Management and histogenesis regarding this prostatic tumor are discussed as is a possible association with other neuroendocrine tumors. Neoplastic disease of the prostate, benign or malignant, infrequently occurs in children and carcinoid of the prostate, either primary or secondary, has not been described at this age, although distribution is widespread. Carcinoid has been isolated from gastrointestinal, biliary, respiratory and genitourinary tracts. Genitourinary sites include the testis, kidney, bladder, urethra, prostate, ovary, cervix and vagina. In regard to prostatic carcinoid recent histopathological findings reveal the presence of enterochromafh cells in the neoplastic and nonneoplastic prostate.1*2 Speculation as to a functional or divergent differentiation from the usual histomorphological type to a carcinoid or carcinoid-like tumor through neoplastic transformation has been made? The majority of reported cases have been associated with adenocarcinoma and as such they have been observed in older men.3*4 We report a unique case of carcinoid of the prostate in a 7-year-old boy without adenocarcinoma, the incidental finding of neuronal intestinal dysplasia in the appendix and the detection of medullary thyroid carcinoma based on investigation of a persistently elevated calcitonin. CASE HISTORY A 7-year-old boy presented with a 3-year history of burning micturition associated in the last year with 2 episodes of gross hematuria. Evaluation was negative for incontinence, frequency, urgency, abdominal pain and systemic symptoms. History included toxic hip synovitis, proximal right leg weakness, distant circumcision and meatotomy. Vital signs were normal, and height and weight were below the 10th percentile. Abdominal and genitourinary examination was unremarkable. Digital rectal examination revealed an asymmetrically enlarged prostate with a prominent right lobe. Urine microscopy and culture, inclusive for tuberculosis and fungi, serum multiple analysis, including calcium and phosphate, and complete blood count were normal. Abdominal and pelvic ultrasound, computerized tomography (CT) and magnetic resonance imaging identified an enlarged inhomogeneous prostate, with elevation of the bladder base and displacement of the urethra to the left side (fig. 1). No other abnormalities, including adenopathy, were noted. Cystoscopic examination confirmed the clinical and radiological picture. A pediatric resectoscope could not be passed, and transrectal ultrasound guided biopsy was performed, which provided a tissue diagnosis of carcinoid. Further clinical staging, including bone scan, CT of the chest and scrota1 ultrasound, was unremarkable. Oncofetal, pheochromocytoma

True mucinous adenocarcinoma of the prostate is a rare morphological variant, accounting for approximately 0.4% of the prostatic adenocarcinomas. Although amounts of mucin confined in the lumina can be demonstrated in a great number of prostatic carcinomas, only those with at least 25% of the resected tumor composed of lakes of extracellular mucin should be classified as true mucinous.1 The impact of the mucinous growth pattern on the clinical course is unclear. Whereas many investigators have suggested that the mucinous variant is less aggressive than the nonmucin producing adenocarcinoma of the prostate, others have observed no difference in clinical symptoms and metastatic behavior.2 For colonic carcinoma it has been demonstrated that extracellular mucin production is an outstanding feature of those tumors revealing microsatellite instability.3 Despite a strong tendency for poor differentiation, microsatellite instability positive colonic carcinomas seem to have a relatively favorable clinical outcome with a reduced likelihood of metastases. To our knowledge no data on molecular changes in the phenotypically related mucinous tumors of the prostate gland are available yet. We report a case of a mucinous adenocarcinoma of the prostate with poor clinical outcome. Molecular analyses revealed high frequency microsatellite instability, indicating a defective mismatch repair to be related to the development of the mucinous prostatic tumor type. CASE REPORT

Analysis of ten primary prostatic tumor cultures using fluorescence in-situ hybridization (FISH) with pericentromeric probes for chromosomes 7, 8, 10, 16, 17, and 18 revealed aneusomies in nine of these specimens. Classical cytogenetics by G-banding indicated that only four of those same ten specimens had any (but not consistent) clonal abnormalities. This preliminary study suggests that aneusomy is a common event in early-stage prostatic tumors, and also supports the notion that multiple chromosomes are involved. In combination with routine cytogenetic analysis, FISH is thus likely to be a powerful tool in the evaluation of prostatic cancer.