case 9. clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic...

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Page 1: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Case 9Case 9

Page 2: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Clinical dataClinical data 50-year-old male with prostatic 50-year-old male with prostatic

symptomatologysymptomatology PSA serum level-normalPSA serum level-normal Homogenous, enlarged soft prostateHomogenous, enlarged soft prostate No focal changes were revealed No focal changes were revealed

ultrasonographicallyultrasonographically Needle biospy: 12 reprezentative Needle biospy: 12 reprezentative

samples 11-21 mmsamples 11-21 mm

Page 3: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

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Page 4: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Striped Basilisc Basiliscus vittatus

Page 5: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

ImmunohistochemistryImmunohistochemistry EMA, AE1-AE3, vimentin-slightly EMA, AE1-AE3, vimentin-slightly

positivepositive

Negative PSA, PAPH, CD 99Negative PSA, PAPH, CD 99

Page 6: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

FISH (event. RT-PCR)FISH (event. RT-PCR) fusion SYT-SSX-positivefusion SYT-SSX-positive

Page 7: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Primary synovial sarcoma of Primary synovial sarcoma of the prostatethe prostate

Page 8: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Synovial sarcomaSynovial sarcoma Synovial sarcoma is Synovial sarcoma is

characterised by characterised by specific translocation specific translocation t(X;18), resulting t(X;18), resulting fusion of gene SYT fusion of gene SYT (18q11) and related (18q11) and related genes SSX1 genes SSX1 (Xp11.23), resp. (Xp11.23), resp. SSX2 (Xp11.21). SSX2 (Xp11.21).

SYT-SSX1 for bifasic SYT-SSX1 for bifasic SSSS

SYT-SSX2 for SYT-SSX2 for monophasis SSmonophasis SS

Page 9: Case 9. Clinical data 50-year-old male with prostatic symptomatology 50-year-old male with prostatic symptomatology PSA serum level-normal PSA serum level-normal

Diferential diagnosticsDiferential diagnostics Leiomyosarcoma of the prostate/ Leiomyosarcoma of the prostate/

leiomyomaleiomyoma Postoperative spindle cell nodulusPostoperative spindle cell nodulus Sarcomatoid TCCSarcomatoid TCC Phylloid tumor of the prostatePhylloid tumor of the prostate