title: Phyllodes tumor of the prostate.
abstract: In this report, we describe a case of phyllodes tumor of the prostate with a high value of prostate-specific antigen (PSA). A 47-year-old man with symptoms of hematospermia presented with a steadily elevated serum PSA value of 60.76 ng/mL (normal range, < 4 ng/mL). A needle biopsy revealed atypical stromal cells without any evidence of malignancy. After radical prostatectomy, the tumor measured 2.9 cm in diameter and consisted of a single nodule composed of irregular, elongated epithelial ducts and atypical stromal cells with enlarged, occasionally multinucleated, pleomorphic, or hyperchromatic nuclei. Immunohistochemistry showed that the atypical stromal cells were positive for vimentin, androgen receptor, estrogen receptor, progesterone, and 5α-reductase, but negative for MIB-1, PSA, SMA, p53, desmin, CD34, c-kit, CD10, S-100, and EGFR. Excess PSA might be secreted by hyperplastic luminal cells driven by 5α-reductase-positive stromal and epithelial cells. Array-comparative genomic hybridization (array CGH) for genomic alterations revealed a gain of 11p13, which includes the WT1 gene, and a loss of 1p36.23 and 12p12.1. After surgery, the serum PSA value rapidly decreased to within the normal range; no recurrence or distant metastasis was noted after 2 years of follow up.
authors.affiliation: Department of Pathology Urology, Nara Medical University School of Medicine, Kashihara, Nara, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Fujii
authors.forename: Keiji
authors.initials: K
authors.lastname: Shimada
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Noboru
authors.initials: N
authors.lastname: Konishi
mesh_terms: D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000097:blood* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen