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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2019.03.25    [Epub ahead of print]
Rectal Invasion by Prostatic Adenocarcinoma That Was Initially Diagnosed from a Rectal Polyp on Colonoscopy
Ghilsuk Yoon1, Man-Hoon Han2, An Na Seo1
1Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
2Department of Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
Corresponding Author: An Na Seo ,Tel: +82-53-200-3403, Fax: +82-53-200-3399, Email: san_0729@naver.com
Received: January 29, 2019;  Revised: March 5, 2019  Accepted: March 25, 2019.  Published online: April 11, 2019.
ABSTRACT
Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed P504S positivity, PSA positivity, and CDX-2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.
Key Words: Prostatic adenocarcinoma, Colonoscopy, Rectum, Polyp
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