Prostate carcinoma metastatic to the skin as an extrammamary Paget's disease.
OBJECTIVE
The current paper describes a case of prostatic adenocarcinoma metastatic to the skin presenting as an extrammamary Paget's disease, a very rare and poorly characterised morphological entity. We report a case of prostatic carcinoma metastatic to skin showing a pattern of extramammary Paget's disease which has not been clearly illustrated in the literature Case presentation: A 63 year-old man with prostatic adenocarcinoma developed cutaneous metastases after 16 years. The inguinal metastases were sessile and 'keratotic.' The tumour displayed solid, glandular areas as well as a polypoid region suggestive of extramammary Paget's disease were identified.


CONCLUSIONS
We review the diagnostic criteria that have led to the correct histopathological diagnosis in this case. A differential diagnosis of the pagetoid spread in the skin and various forms of cutaneous metastases determined by a prostatic adenocarcinoma as well as the role of immunohistochemistry in establishing the prostatic origin are presented in the context of this case. Although, morphologically the cells presented in the skin deposits were not characteristic for adenocarcinoma of prostate, immunohistochemistry for PSA and PSAP suggested a prostatic origin.
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Griffith University School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia. e_petcu@hotmail.com
Eugen Bogdan
EB
Petcu
Aldo
A
Gonzalez-Serva
Robert G
RG
Wright
Mark
M
Slevin
Klara
K
Brinzaniuc
D000230:Adenocarcinoma / Q000737:chemistry / Q000556:secondary*; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007610:Kallikreins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000737:chemistry / Q000473:pathology*; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000473:pathology*; D049231:Saposins / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000556:secondary*
C483345:PSAP protein, human; D049231:Saposins; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen