case_images: PMC7786235_01
case_images: Ultrasound detected a non-uniform hypoechoic nodule, about 34 mm x 25 mm x 29 mm in size, in the right lateral lobe of the prostate with the obscure boundary. No marked color flow signal was observed within the lesion upon Color Doppler flow imaging. (A) Transverse position. (B) Sagittal position.
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case_images: f1
case_images: Ultrasonographic examination indicated benign prostatic hyperplasia and a prostatic space occupying lesion ( Figure 1 ).
case_images: MRI detected a round-like mixed signal lesion in the right lobe of the prostate. T2WI showed mixed signal, with high signal around the periphery and a cluster-like low signal in the center. The lesion boundary was clear, with visible capsule, and the diameter was about 36 mm. The right peripheral zone of the prostate was compressed. (A) Axial T2-weighted Image. (B) Coronal Fat-suppressed T2-weighted Image.
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case_images: Magnetic resonance imaging (MRI) manifested a prostatic space occupying lesion, presenting mixed signals, with a strong signal around the periphery and cluster-like low signals in the right lobe, at a diameter of about 36 mm ( Figure 2 ).
case_images: Histopathological and immunohistochemical findings of the tumor. (A) Hematoxylin and Eosin stained section of needle biopsy found prostate tissue with interstitial edema around the acinar, part of which showed mucus edema-like changes. (B) Hematoxylin and Eosin stained section of TUPKP specimen manifested multifocal mucinous adenocarcinoma with diffuse infiltration. GS was 4 + 3 = 7. Immunohistochemical staining showed positive for PSA (C) and PSAP (D), and MUC2 staining showed ~20% positivity (E).
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case_images: The histopathological examination found no definite malignancy ( Figure 3A ). Figure 3B ). Further immunohistochemical staining showed sections were tested positive for PSA and prosaposin (PSAP) ( Figures 3C, D ), and negative for caudal type homeobox 2 (CDX-2), cytokeratin-20 (CK20), alpha-methylacyl-CoA racemase (AMACR, P504S), cytokeratin-5/6 (CK5/6), cytokeratin-7 (CK7), high molecular weight cytokeratin 34betaE12, and transformation-related protein 63 (P63), and Mucin-2 (MUC2) staining revealed ~20% positivity ( Figure 3E ).
case_images: Urethrocystoscopic performance of the tumor. (A) Two cord-like neoplasm located at the apex of the prostate and extended from the right of verumontanum to the neck of the bladder. (B) A multi-chamber cystic mass surrounded a region of the prostate gland that lacked blood supply. (C) Mucous substance can be observed on the cut surface.
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case_images: f4
case_images: Both of them had pedicles that were located at the prostatic apex on the right side of the verumontanum ( Figures 4A, B ). Figure 4C ). For the purpose of pathological diagnosis, the surgery aimed to remove the whole tumor with clean margins.