PMC7970671_01
The repeat prostate biopsy revealed recurrent prostate cancer with disease progression, showing a Gleason score 9, Grade 5 adenocarcinoma (a). The microscopic examination of radical prostatectomy showed moderately to poorly differentiated adenocarcinoma (prostatic acinar type, Gleason score 9, Grade 5) (b). The histologic analysis of cystectomy with bilateral pelvic lymph node dissection revealed poorly differentiated metastatic prostate adenocarcinoma (c), and a small 2 mm focus of poorly differentiated metastatic prostate adenocarcinoma was found in the outer wall of the urinary bladder (d).
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The biopsy revealed recurrent prostate cancer with disease progression, showing a Gleason score 9, Grade 5 adenocarcinoma, in 6/10 cores, with perineural invasion (Figure 1(a)), and a Gleason score 8, Grade 4 adenocarcinoma, in 2/10 cores. The microscopic examination showed moderately to poorly differentiated adenocarcinoma (prostatic acinar type, Gleason score 9, Grade 5) with perineural invasion (Figure 1(b)). The histologic analysis of the lymph node dissection revealed positive right common iliac, inferior vena cava lymph node, and right pelvic lymph nodes for poorly differentiated metastatic prostate adenocarcinoma (Figure 1(c)). A small 2 mm focus of poorly differentiated metastatic prostate adenocarcinoma was found in the outer wall of the urinary bladder (Figure 1(d)).
The appendix showed poorly differentiated metastatic prostate adenocarcinoma, involving the appendiceal wall with mesoappendix, perineural, and lymphovascular invasion (a). Besides the metastatic carcinoma, high-grade appendiceal mucinous neoplasm (HAMN) of appendix was also found incidentally, with acellular mucin extending to the muscularis mucosae in a background of mild focal early acute appendicitis (b, c, d).
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He underwent subsequent laparoscopic appendectomy, and histologic examination of the appendix showed poorly differentiated metastatic prostate adenocarcinoma (Figure 2(a)), involving the appendiceal wall with mesoappendix, perineural, and lymphovascular invasion. Besides the metastatic carcinoma, HAMN of appendix was also found incidentally, with acellular mucin extending to the muscularis mucosae in a background of mild focal early acute appendicitis (Figure 2(b)-(d)).
An abdominal CT showed a 6.1 cm large heterogeneous rectal mass (a) and biopsy showed a poorly differentiated malignancy with spindle cell features (b).
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An abdominal CT scan showed a 6.1 cm large heterogeneous rectal mass concerning for recurrent prostate cancer (Figure 3(a)). A biopsy was performed and showed a poorly differentiated malignancy with spindle cell features (Figure 3(b)).