前立腺乳頭状嚢胞腺癌の1例

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63歳男.10年来の排尿困難を主訴とした.直腸診上,前立腺は軽度腫大し前立腺特異抗原(PSA)は2.9ng/mlであった.超音波検査では膀胱内に突出する嚢胞性病変を認め,経皮的穿刺吸引で穿刺液は暗赤色,細胞診はclassIIであった.1年間外来にて経過観察していたが,排尿困難増悪のため経尿道的前立腺切除術を施行し,貯留性嚢胞と思われた部分もほとんど切除した.病理組織像では腫瘍細胞が著明な乳頭状構築を示して嚢胞壁内面を覆い,PSA染色陽性を示した.前立腺乳頭状嚢胞腺癌stageBの診断で前立腺全摘除術を施行したが残存する癌は認めず,術後21ヵ月経過現在,癌なし生存中であるA 63-year-old man presented with dysuria. Ultrasonography revealed a cystic intravesical mass. During needle aspiration we aspirated bloody fluid. The result cytology was class II. We gave medication on an outpatient basis, but symptoms became worse. We performed transurethral resection (TUR) of prostate. Histopathological examination of the TUR specimen revealed a papillary cystadenocarcinoma of the prostate. We diagnosed the tumor as a stage B prostate cancer, and performed total prostatectomy. Histopathological examination of prostate revealed no residual cancer. Eleven cases of papillary cystadenocarcinoma of the prostate in the Japanese literature are reviewed briefly.