International Journal of Clinical Case Reports 2017, Vol.7, No.8, 33-37
33
Case Report
Open Access
Adenoid Cystic Carcinoma of Prostate: A Rare Case Report
Shailee Mehta , Priti Trivedi, Nisha Khanna, Satarupa Samanta, Dhaval Jetly
Department of Pathology, Gujarat Cancer and Research Institute, Civil hospital campus, Asarwa Ahmedabad-380016, Gujarat, India
Corresponding author email:
International Journal of Clinical Case Reports 2017, Vol.7, No.8 doi:
Received: 14 Jun., 2017
Accepted: 10 Jul., 2017
Published: 20 Jul., 2017
Copyright © 2017
Mehta et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Mehta S., Trivedi P., Khanna N., Samanta S., and Jetly D., 2017, Adenoid cystic carcinoma of prostate: a rare case report, 7(8): 33-37 (doi:
)
Abstract
Adenoid Cystic Carcinoma of the prostate is a rare variant of prostatic adenocarcinoma considered to have an indolent
biological potential. However, outcome data are scant. We report a case of 49 year old male who presented with urinary obstruction.
Digital rectal examination and ultrasound revealed enlarged hard nodular prostate. His serum PSA level was 0.729 ng/ml.
Histologically, Adenoid cystic or cribriform pattern with prominent peri-neural invasion was seen on TURP chips and it was
immunoreactive for c-KIT. After the diagnosis, patient underwent radical prostatectomy. Patient was clinically stable during a limited
follow up of two months.
Keywords
Adenoid cystic; Prostate
Introduction
Prostate cancer is a common malignancy in males worldwide. Acinar adenocarcinoma accounts for the majority of
prostatic malignancies. Adenoid cystic carcinoma (ACC) of prostate is a rare entity constituting only about 0.01%
of malignancies of prostate. ACC is usually found in major and minor salivary glands and infrequently in breast
tissue. This tumor was first reported in salivary gland as a tumor with cribriform, glandular, and basaloid patterns
containing mucous material. In prostate it arises from basal cell of prostatic ducts and acini. Only few case reports
of ACC of prostate are available. We report a rare case of prostatic ACC in 49 year old male.
1 Case Report
A 49-year-old man came to the out-patient facility of Gujarat Cancer and Research Institute with complaints of
urinary hesitancy, increase in frequency and nocturia since last 2 years with symptoms being aggravated since 3
months. There was no history of hematuria or any other significant previous medical history. His lab reports like
hemogram and RFT were within normal range with Hb-12.3 g/dl, TLC-7700/cumm, Platelet count-441000/cumm,
BUN-6 mg/dl and S.creatinine -0.67 mg/dl. Digital Rectal Examination (DRE) revealed a hard, palpable,
non-tender and fixed nodular mass in prostate. Serum PSA level was within normal range (0.729 ng/mL). Due to a
suspicious DRE, trans-rectal ultrasonography (TRUS)-guided routine, 12 core biopsies were taken from the
prostate and sent for histopathological examination.
Histopathological examination revealed monomorphic tumor cells arranged in a cribriform pattern with
intraluminal basophilic mucinous secretion (Figure 1). These tumor cells were small with scant cytoplasm and
angulated hyperchromatic nuclei (Figure 2). Focally, the glands showed infiltration into the prostatic
fibromuscular tissue (Figure 3). Perineural invasion was evident in the sections examined. Special stains like
Periodic Acid Schiff (PAS) and Mucicarmine also stained mucin (Figure 4).
Immunohistochemistry with monoclonal antibody for PSA was negative. c-kit showed strong cytoplasmic
positivity (Figure 5). Ki-67 index showed 30% positivity. Diagnosis of ACC was made which was followed by
radical prostatectomy. The patient was clinically stable during post-operative period. There was no progression of
disease during the 2 months of follow-up.
