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Year : 2018  |  Volume : 61  |  Issue : 3  |  Page : 452-453
Ectopic prostatic tissue presenting as a mucosal tumor in urinary bladder


1 Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
2 Department of Urology, Kalinga Hospitals, Bhubaneswar, Odisha, India

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Date of Web Publication13-Jul-2018
 

How to cite this article:
Adhya AK, Pradhan MR. Ectopic prostatic tissue presenting as a mucosal tumor in urinary bladder. Indian J Pathol Microbiol 2018;61:452-3

How to cite this URL:
Adhya AK, Pradhan MR. Ectopic prostatic tissue presenting as a mucosal tumor in urinary bladder. Indian J Pathol Microbiol [serial online] 2018 [cited 2019 Dec 12];61:452-3. Available from: http://www.ijpmonline.org/text.asp?2018/61/3/452/236595




A 56-year-old male patient presented with repeated bouts of painless hematuria. On cystoscopic evaluation, a nodular polypoidal growth was found in the trigone area of the urinary bladder. The overlying surface of the nodule was smooth. Biopsy taken from the area revealed a well-circumscribed nodular collection of benign prostatic acinar glands and stroma. The overlying surface urothelium was intact. There was no evidence of malignancy. Immunohistochemistry with prostate-specific antigen (PSA) and cytokeratin 5/6 confirmed benign nature of these prostatic glands [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d.
Figure 1: (a) photomicrograph showing intact transitional epithelium and a well-circumscribed nodule of glandular structures in the subepithelium (H and E, ×100). (b) high-power view of the nodule showing benign prostatic acini with double-layered epithelium and fibromuscular stroma (H and E, ×400). (c) Immunohistochemistry with prostate-specific antigen shows strong positivity in the glandular epithelial cells (×200). (d) Immunohistochemistry with cytokeratin 5/6 shows a continuous basal cell layer (×400)

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Ectopic prostatic tissue in the urinary bladder is rare and <50 cases have been reported in literature. Most of them occur at the trigone area and rarely at the bladder neck of periurethral location.[1] Prostatic ectopia in urinary bladder may be due to the persistence of prostatic tissue during embryogenesis [2] or metaplasia of the urinary epithelium due to chronic inflammation [3] or migration of prostatic stem cells from the usual sites to abnormal locations.[4] In our case, the third theory is more likely as there was no inflammation in the biopsy and embryonic remnants usually appear in the urethra and periurethral regions.

The lesion may clinically mimic a bladder mucosal tumor. On a small biopsy, it may be confused with a well-differentiated adenocarcinoma. Hence, awareness of this entity is essential for both urologists and pathologists to prevent misdiagnosis of malignancy. These lesions usually are small and have a smooth surface, unlike urothelial neoplasms which are commonly papillary. A simple resection of the lesion was curative in our case. Adenocarcinoma arising within the ectopic prostatic tissue has also been reported; hence, its early detection and treatment are essential.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Bellezza G, Sidoni A, Cavaliere A. Ectopic prostatic tissue in the bladder. Int J Urol 2005;12:1066-8.  Back to cited text no. 1
    
2.
Delladetsima J, Theodorou C, Dapolla Y, Dimopoulos C. Prostatic-type epithelium in urinary bladder. Clinical, histologic, and immunohistochemical study. Urology 1990;36:445-8.  Back to cited text no. 2
    
3.
Dogra PN, Ansari MS, Khaitan A, Safaya R, Rifat. Ectopic prostate: An unusual bladder tumor. Int Urol Nephrol 2002;34:525-6.  Back to cited text no. 3
    
4.
Fulton RS, Rouse RV, Ranheim EA. Ectopic prostate: Case report of a presacral mass presenting with obstructive symptoms. Arch Pathol Lab Med 2001;125:286-8.  Back to cited text no. 4
    
5.
Backhouse A, Vasilaras A, Yung T, Kench JG. Adenocarcinoma arising within ectopic prostatic tissue in the urinary bladder. Pathology 2014;46:655-7.  Back to cited text no. 5
    

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Correspondence Address:
Amit Kumar Adhya
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_131_18

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