PRIMARY CARCINOID TUMOR OF THE PROSTATE

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  • 前立腺原発カルチノイドの1例
  • ゼンリツセン ゲンパツ カルチノイド ノ 1レイ
  • Report of a Case

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A case of primary prostatic carcinoid tumor is reported.<br>A 61-year-old man was hospitalized in October, 1976, because of dysuria, urinary frequency and perineal pain. There was no history of diarrhea, abdominal discomfort or flushing.<br>Physical examination revealed an enlarged, stony hard prostatic gland that was irregular in contour and consistency, giving the impression of carcinoma of the prostate. However, carcinoid tumor was diagnosed following examination of transrectal prostatic needle biopsy material.<br>Radiographically, a retrograde urethrocystogram demonstrated a trabeculated bladder and narrowing prostatic urethra, but the chest, skeletal system and entire alimentary tract were normal.<br>Routine laboratory data were within normal limits except for the serum serotonin level which was 345μg/l (normal level is under 125μg/l).<br>Pelvic evisceration with construction of an ileal conduit and preternatural anus was performed on November 11, 1976, and iliac lymph nodes were dissected.<br>Grossly, the tumor was solid and localized in the prostate, and there was scarcely normal prostatic tissue. Histologically, the tumor was composed of nodular solid nests, rossete-like structures and peripheral pallisading. Lymph nodes dissected showed the same structures. Histochemically, the tumor cells were positive for the argyrophil reaction by Glimelius silver stains, but negative for argentaffin reaction by Masson-Fontana silver stains. Electronmicroscopically, the tumor cells had characteristic secretory granules.<br>As a result, the pathological diagnosis of this tumor was determined as a primary carcinoid tumor of the prostate.<br>The patient received intravenously 5-FU for about one month after the operation. However, the clinical course of the patient was rapidly downhill, and he died of cachexia four months after the operation. Autopsy was not performed.<br>To our knowledge, this is the first case of primary prostatic carcinoid tumor reported in Japan.

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