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[Cystic carcinoma of the prostate. Echographic diagnosis]
F Herranz Amo1, J M Díez Cordero, F Verdú Tartajo
1Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Objective:
To analyze the incidence of cystic cancer in our series of patients with prostatic cancer diagnosed by US-guided transrectal prostate biopsy and to describe the clinical and ultrasound features.
Methods:
Of 497 cases of prostatic cancer diagnosed by US-guided transrectal biopsy, 369 (74%) showed a hypoechoic nodule, 15 (3%) had a hyperechoic nodule, 17 (3%) showed a mixed echogenicity, 3 (0.6%) had a cystic lesion and 96 (19%) were isoechoic. The 3 patients with cystic cancer of the prostate are analyzed.
Results:
In these three cases ultrasound showed a large, weakly echogenic, prostatic cystic lesion with mammillated margins. Punction-aspiration of the cyst yielded 20 and 7 cc of bloody liquid. The prostate was biopsied. Pathological analysis showed a typical prostatic adenocarcinoma in cases one and three; small areas of endometriod carcinoma were found in case two. The cytological analyses and cultures of the cystic liquid were negative in all three cases. Complementary studies were done; cases one and three were classified as disseminated tumor and case two as locally advanced tumor.
Conclusions:
In our series, cystic carcinoma of the prostate accounts for 1% of prostate carcinomas. Punction-aspiration is advocated for prostatic cystic lesions with irregular margins. Bloody or dark cystic liquid warrants a prostate biopsy including cyst wall.