Secondary rectal linitis plastica caused by prostatic adenocarcinoma - magnetic resonance imaging findings and dissemination pathways: A case report.

BACKGROUND: Secondary rectal linitis plastica (RLP) from prostatic adenocarcinoma is a rare and poorly understood form of metastatic spread, characterized by a desmoplastic response and concentric rectal wall infiltration with mucosal preservation. This complicates endoscopic diagnosis and can mimic gastrointestinal malignancies. This case series underscores the critical role of magnetic resonance imaging (MRI) in identifying the distinct imaging features of RLP and highlights the importance of considering this condition in the differential diagnosis of patients with a history of prostate cancer. CASE SUMMARY: Three patients with secondary RLP due to prostatic adenocarcinoma presented with varied clinical features. The first patient, a 76-year-old man with advanced prostate cancer, had rectal pain and incontinence. MRI showed diffuse prostatic invasion and significant rectal wall thickening with a characteristic "target sign" pattern. The second, a 57-year-old asymptomatic man with elevated prostate-specific antigen levels and a history of prostate cancer exhibited rectoprostatic angle involvement and rectal wall thickening on MRI, with positron emission tomography/computed tomography PSMA confirming the prostatic origin of the metastatic spread. The third patient, an 80-year-old post-radical prostatectomy, presented with refractory constipation. MRI revealed a neoplastic mass infiltrating the rectal wall. In all cases, MRI consistently showed stratified thickening, concentric signal changes, restricted diffusion, and contrast enhancement, which were essential for diagnosing secondary RLP. Biopsies confirmed the prostatic origin of the neoplastic involvement in the rectum. CONCLUSION: Recognizing MRI findings of secondary RLP is essential for accurate diagnosis and management in prostate cancer patients.

Carcinoma prostático em gato - relato de caso e revisão de literatura / Prostatic carcinoma in a cat - case report and literature review / Carcinoma prostático en un gato - reporte de caso y revisión de la literatura

A neoplasia prostática em gatos é rara e pouco descrita na literatura. Não é um tumor andrógeno dependente, e a castração não ajuda na prevenção ou no tratamento. Técnicas ultrassonográficas e radiográficas evidenciarão compressão uretral ou retal na posição da neoplasia, e para diagnóstico definitivo deve-se realizar exame histopatológico. Não há protocolo terapêutico eficaz estabelecido, e o tratamento cirúrgico não costuma ser efetivo no controle da evolução do quadro, já que é de caráter maligno, agressivo e com altas taxas de metástases. Relata-se o caso de um gato macho, castrado, sem raça definida, de pelo curto, 10 anos, com histórico de disquesia, fezes em fita, hematuria e normorexia. O diagnóstico presuntivo foi realizado por meio de ultrassonografia; no entanto, devido à caracteristica obstrutiva apresentada pela neoplasia, assim como ao prognóstico de reservado a ruim em relação às alternativas terapêuticas, optou-se pela eutanásia, e não foi evidenciada nenhuma metástase.(AU)

Prostatic neoplasia in cats is rare and poorly described in the literature. It is not an androgen dependent tumor, and castration does not help in prevention or treatment. Ultrasonographic and radiographic techniques will show urethral or rectal compression in the position of the neoplasm, and for a definitive diagnosis. histopathological examination must be performed. There is no effective therapeutic protocol established, and surgical treatment is not usually effective in controlling the evolution of the condition, since it is malignant, aggressive and has high rates of metastases. The patient in this report is a 10-year-old male, neutered, mixed- breed, short-haired cat, with a history of dyschesia, ribbon-like stools, hematuria and normorexia. The presumptive diagnosis was performed by ultrasound; however, due to the obstructive characteristic presented by the neoplasm, as well as the poor prognosis in relation to the therapeutic alternatives, euthanasia was chosen, and no metastasis was evidenced.(AU)

La neoplasia prostática en gatos es rara y está pobremente descrita en la literatura. No es un tumor dependiente de andrógenos, y la castración no ayuda en la prevención ni en el tratamiento. Las técnicas ultrasonográficas y radiográficas mostrarán compresión uretral o rectal en la posición de la neoplasia, y para un diagnóstico definitivo se debe realizar un examen histopatológico. No existe un protocolo terapéutico eficaz establecido, y el tratamiento quirúrgico no suele ser eficaz para controlar la evolución del cuadro, ya que es maligno, agresivo y presenta altas tasas de metástasis. El paciente de este reporte es un gato macho de 10 años. castrado, mestizo, de pelo corto, con antecedentes de disquesia, heces en cinta. hematuria y normorexia. El diagnóstico presuntivo se realizó por ecografia; sin embargo, debido al carácter obstructivo que presentaba la neoplasia, así como al mal pronóstico en relación a las alternativas terapéuticas, se optó por la eutanasia y no se evidenció metástasis.(AU)

CXXC5 expression in prostate cancer: implications for cancer progression.

Identification of genes specifically deregulated in prostate adenocarcinoma may lead to discovery of new oncogenes/tumour suppressors with clinical relevance for diagnosis, prognosis and/or therapy. CXXC5 is a gene encoding a retinoid-inducible nuclear factor, whose overexpression in breast tumours, metastatic malignant melanomas and papillary thyroid carcinoma has been recently reported. We previously found differential expression of CXXC5 transcripts in metastatic prostate cancer cell lines of both rat and human origin. However, knowledge on the expression of this gene in benign or malignant human prostate tissue is lacking. The aim of this study was to determine the mRNA and protein expression pattern of CXXC5 in human benign prostate tissue, proliferative inflammatory atrophy, high-grade prostatic intra-epithelial neoplasia and prostate cancer, using qPCR, chromogenic in situ hybridization and immunohistochemistry. Our results showed that protein levels determined by immunohistochemistry were in agreement with transcript levels observed by chromogenic in situ hybridization. CXXC5 mRNA and protein expressions were significantly higher in prostate cancer, high-grade prostatic intra-epithelial neoplasia, and proliferative inflammatory atrophy, compared to benign prostate tissue. Significantly, within the same tissue specimens, CXXC5 staining was stronger in malignant acini than in matched adjacent, benign acini; immunostaining for this protein was mainly localized to the nucleus of benign epithelial cells and both the nucleus and cytoplasm of malignant epithelial cells. Our findings suggest that CXXC5 may play a role in the process of prostate carcinogenesis. Additional studies are required to determine the biological and clinical significance of CXXC5 in prostate cancer development and/or progression.

Adenocarcinoma de próstata de volumen mínimo: estudio de 12 casos en piezas de prostatectomía / Minimal volume prostatic adenocarcinoma: study of 12 cases in specimens of radical prostatectomy

Adenocarcinoma de volumen mínimo es aquella neoplasia menor de 0,5 cm³ en prostatectomía radicales. Son tumores de pronóstico excelente, generalemente ógano-confinados y totalmente resecados. Seleccionamos 12 casos de adenocarcinoma con un volumen de 0,5 cm³ en piezas de prostatectomias radicales. El promedio de edades fue 60,55 años. Los tumores eran órgano-confinados y el Gleason osciló entre 5 y 9. El promedio del diámetro tumoral fue 4,9 mm y del volumen fue 0,129 cm³. Las biopsias por punción fueron revisadas en 9 de los 12 pacientes. En ellas el porcentaje tumoral ocupaba entre 3% y 30% de la totalidad de la biopsia. Consideramos que para el diagnóstico del adenocarcinoma de volumen mínimo en la pieza de prostatectomía radical se debe estudiar la totalidad del espécimen en forma sistemática, ya que el diagnóstico de carcinoma de volumen mínimo en la biopsia por punción puede no corresponder con un tumor menor de 0,5 cm³ en la prostatectomía radical

Minimal volume prostactic adenocarcinoma is defined as a neoplasia less than 0.5 cm³ in radical prostatectomy. These are tumors of excellent prognosis, generally organ confined, and totally resected. We selected 12 cases of adenocarcinoma with less than 0.5 cm³ in volumen in specimens of radical prostatectomy. The average age was 60.55 years. Tumors were organ-confined and the Gleason score rangel from 5 to 9. The average tumor diameter was 4.9 mm and volume was 0.129 cm³. Needle biopsies were studied in 9 out of 12 patients. In these, the tumor percentage in biopsy was from 3% to 30%. We consider that for the diagnosis of a minimal volume adenocarcinoma in the specimen of radical prostatectomy, the specimen must be totally and systematically submitted and studied, since the diagnosis of minimal volume carcinoma in the core biopsy might not correspond with a tumor of less than 0.5 cm³ in the radical prostatectomy

RASTREAMENTO DO ADENOCARCINOMA PROSTÁTICO EM VOLUNTÁRIOS DE UMA REGIÃO DA BAHIA: RESULTADOS PRELIMINARES

The objective of the study was to assess the prevalence of the prostate adenocarcinoma in volunteers, between 40 and 80 years of age, from a northeastern region of Brazil. All volunteers were submitted to a digital rectal examination and total PSA blood level determination. A total of 499 men were evaluated. Prostatic biopsy guided by transrectal ultrasound (5 cores/ lobe) was indicated to those with PSA higher than 2ng/ml and/or prostatic changes on the DRE. Biopsies were carried out in 120 of 135 men that filled those criteria. Prostate adenocarcinoma was found in 24 volunteers corresponding to 5.1% of the sample. Such prevalence seems higher than that reported for men living in the southeastern area of the country. Differences might be a consequence of racial or environmental factors, but it is not possible to rule out other factors such as a methodological bias.

O estudo teve como objetivo a determinação da prevalência do adenocarcinoma prostático em uma amostra de voluntários entre 40 e 80 anos de idade de uma região nordestina. Os voluntários foram recrutados da comunidade e submetidos ao toque retal e à dosagem do PSA total. Compareceram 499 homens para essa avaliação inicial. Aqueles com PSA maior que 2ng/ml e/ou toque retal suspeito tiveram a biópsia indicada. De 135 homens com indicação de biópsia, 120 compareceram para o exame. A biópsia guiada por ultra-som consistiu da retirada de 10 fragmentos (5/lobo). O adenocarcinoma prostático foi encontrado em 24 voluntários, o que corresponde a 5,1% dos casos. Essa prevalência parece mais elevada que a observada em voluntários da região sudeste do país. A diferença pode ser conseqüência de fatores genéticos ou ambientais, mas não se pode descartar outros fatores como variações metodológicas.

Rastreamento do adenocarcinoma prostático em voluntários de uma região da bahia: resultados preliminares

The objective of the study was to assess the prevalence of the prostate adenocarcinoma in volunteers, between 40 and 80 years of age, from a northeastern region of Brazil. All volunteers were submitted to a digital rectal examination and total PSA blood level determination. A total of 499 men were evaluated. Prostatic biopsy guided by transrectal ultrasound (5 cores/ lobe) was indicated to those with PSA higher than 2ng/ml and/or prostatic changes on the DRE. Biopsies were carried out in 120 of 135 men that filled those criteria. Prostate adenocarcinoma was found in 24 volunteers corresponding to 5.1% of the sample. Such prevalence seems higher than that reported for men living in the southeastern area of the country. Differences might be a consequence of racial or environmental factors, but it is not possible to rule out other factors such as a methodological bias.

O estudo teve como objetivo a determinação da prevalência do adenocarcinoma prostático em uma amostra de voluntários entre 40 e 80 anos de idade de uma região nordestina. Os voluntários foram recrutados da comunidade e submetidos ao toque retal e à dosagem do PSA total. Compareceram 499 homens para essa avaliação inicial. Aqueles com PSA maior que 2ng/ml e/ou toque retal suspeito tiveram a biópsia indicada. De 135 homens com indicação de biópsia, 120 compareceram para o exame. A biópsia guiada por ultra-som consistiu da retirada de 10 fragmentos (5/lobo). O adenocarcinoma prostático foi encontrado em 24 voluntários, o que corresponde a 5,1% dos casos. Essa prevalência parece mais elevada que a observada em voluntários da região sudeste do país. A diferença pode ser conseqüência de fatores genéticos ou ambientais, mas não se pode descartar outros fatores como variações metodológicas.

Metástase cerebral como manifestação inicial de adenocarcinoma de próstata / Cerebral metastases as the first manifestation of prostatic adenocarcinoma

O acometimento do sistema nervoso central por neoplasia primária de próstata é raro. Cerca de 2% a 4% dos pacientes com adenocarcinoma de próstata disseminado apresentam metástases parenquimatosas para cérebro ou medula espinhal. A metástase cerebral por adenocarcinoma de próstata ocorre por disseminação hematogênica a distância, somenteapós comprometimento dos ossos e pulmões. Os autores descrevem dois casos de metástases cerebrais como manifestação inicial de adenocarcinoma de próstata, sem acometimento clínico de outros órgãos. Discutem sua via de disseminação e prognóstico. Sem dúvida, pode haver lesão em outros órgãos que não se manifestaram clinicamente e apresentam um péssimo prognóstico.

Intracranial metastases from adenocarcinoma of the prostate is rare. The incidence of metastatic prostatic cancer in the brain or spinal cord is approximately 2 to 4 percent in large series. Brain metastases tases from prostatic adenocarcinoma can be explained by distance hematogenic widespread after secundary focus in the bone or lung. The authors report two patients with intracranial metastases as the first manifestation of prostate cancer, with no symptoms in other sites.