title: Seminal vesicle intraepithelial involvement by prostate cancer: putative mechanism and clinicopathological significance.
abstract: We have recently shown seminal vesicle intraepithelial involvement of prostate cancer in cases with seminal vesicle invasion (pT3b). Based on the manner of seminal vesicle invasion, there could be 2 possible mechanisms of seminal vesicle intraepithelial involvement: direct intraepithelial invasion from prostate carcinoma in the muscular wall of seminal vesicles or intraepithelial involvement of cancer from the invaginated extraprostatic space (IES)/ejaculatory duct system to extraprostatic seminal vesicle. We aimed to clarify the manner and clinicopathological significance of seminal vesicle intraepithelial involvement. Of 1629 consecutive radical prostatectomies, 109 cases (6.7%) showed seminal vesicle invasion in whole-mounted radical prostatectomy specimens. In these pT3b cases, 18 (17%) showed seminal vesicle intraepithelial involvement by prostate cancer. Stromal invasion of the IES/ejaculatory duct system and ejaculatory duct intraepithelial invasion by prostate cancer were identified in 62 and 5 of 109 pT3b cases, respectively. However, the presence/absence of IES/ejaculatory duct system involvement by prostate cancer does not predict seminal vesicle intraepithelial involvement. No statistically significant correlation was observed between all pathologic parameters/biochemical recurrence and the presence/absence of seminal vesicle intra-epithelial involvement in the pT3b cases. These findings suggest that seminal vesicle intraepithelial involvement is more likely due to direct invasion of carcinoma from the muscular wall of seminal vesicles rather than intraepithelial extension from the ejaculatory duct system in the IES. Further studies with a substantially greater case number are needed to clarify the clinicopathological significance of seminal vesicle intraepithelial involvement in a better manner.
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Miyai
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Kristiansen
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Sergio
authors.initials: S
authors.lastname: Pina-Oviedo
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.
authors.forename: Mukul K
authors.initials: MK
authors.lastname: Divatia
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX; Weill Cornell Medical College of Cornell University, Houston, TX.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Shen
authors.affiliation: Department of Urology, Houston Methodist Hospital, Houston, TX.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Miles
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX; Weill Cornell Medical College of Cornell University, Houston, TX.
authors.forename: Alberto G
authors.initials: AG
authors.lastname: Ayala
authors.affiliation: Department of Pathology Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Yong Wook
authors.initials: YW
authors.lastname: Park
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX; Weill Cornell Medical College of Cornell University, Houston, TX. Electronic address: jaero@houstonmethodist.org.
authors.forename: Jae Y
authors.initials: JY
authors.lastname: Ro
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology*; D004543:Ejaculatory Ducts / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology*; D012669:Seminal Vesicles / Q000473:pathology*
keywords: Intraepithelial involvement; Pathogenesis; Prostate; Prostate cancer; Seminal vesicle invasion