Ana Marinho1,2*, Rui Almeida2,3, Vitor Sousa2,3, Edgar Tavares-da-Silva1,2, Pedro Simões1 and Arnaldo Figueiredo1,2
1Department of Urology and Renal Transplantation, Hospital and University Center of Coimbra, Portugal 2Department of Medicine of Coimbra, University of Coimbra, Portugal 3Department of Pathological Anatomy, Hospital and University Center of Coimbra, PortugalFulltext PDF
Primary signet cell adenocarcinoma of the prostate occurs in 2.5% of cases of prostate adenocarcinomas. Signet ring is a term used to describe the histologic appearance of a tumor cell characterized by compression of the nucleus into the form of a crescent by a large cytoplasmatic vacuole. Generally, it is diagnosed at a later stage and has a worse prognosis when compared to classic prostatic adenocarcinoma. We report a case of a 54-year-old asymptomatic man referred to Urology in June 2021. He had a total PSA of 4.23 ng/ml with a 12% Free/Total PSA ratio. A multiparametric magnetic resonance image, performed in August 2021, revealed a suspected area in the right side, poorly defined, located in the middle third and apical region at anterior and posterolateral location, measuring 28 mm × 9 mm, PI-RADS 5. A prostate biopsy identified acinar adenocarcinoma in 15% of the fragments of the right lobe, Gleason 8 (4+4). Staging PET-PSMA described a right lobe focus with high intensity of uptake. The patient underwent radical prostatectomy and extended pelvic lymph node dissection in November 2021. The histology revealed a poorly differentiated acinar adenocarcinoma of the prostate, variant signet cells (30%), Gleason grade 9 (4+5), involving 10% of the right lobe tissue (peripheral zone of apex, lower and middle floor), pT2aN0, negative margins. After surgery the PSA was <0.06 ng/ml.
Marinho A, Almeida R, Sousa V, Tavares-da-Silva E, Simões P, Figueiredo A. Primary Signet Cell Adenocarcinoma of the Prostate pT2aN0 in Radical Prostatectomy Specimen of a Young Male: Case Report and Literature Review. Ann Clin Case Rep. 2022; 7: 2141..