[Cystic adenoid carcinoma of the prostate. Report of two cases].

OBJECTIVE

We report two cases with the pathologic diagnosis of cystic adenoid carcinoma of the prostate, an extremely rare tumor.

METHODS

We evaluate two patients with different age, clinical presentation, diagnosis, treatment and outcome.

RESULTS

The ages were 41 and 59, the symptoms perineal pain and lower urinary tract symptoms, on digital rectal examination a round hard tumor mass and normal exam, respectively. PSA and prostatic acid phosphatase were normal; Transrectal ultrasound may be normal or find a hypoechoic node. The first patient underwent radical prostatectomy and adjuvant immunotherapy; six years after surgery he developed lung metastasis and died. The second patient underwent radical cystoprostatectomy with orthotopic urinary diversion with good outcome after two years of follow-up.

CONCLUSIONS

The clinical presentation is non specific, with the diagnosis generally obtained by transurethral resection or transrectal biopsy after the suspicion of an abnormal digital rectal examination or ultrasound. The tumor is immunoreactive to p53 and citokeratins 7 and 34 Beta E12, and the treatment of choice is radical cystoprostatectomy because it is a potentially aggressive neoplasia; adjuvant treatment may be added.