Gülgün ERDOĞAN, Mehmet Akif ÇİFTÇİOĞLU, Cumhur İbrahim BAŞSORGUN, Ceren UZUN, Mehmet BAYKARA, Betül ÜNAL, İrem Hicran ÖZBUDAK

Embriyonal Prostatik Rabdomyosarkom:Olgu Sunumu

Sarkomlar tüm prostat malignensilerinin %0,1-0,2'sini oluşturur. Rabdomyosarkom, iskelet kası (sarkomerik) diferansiasyonu gösteren malign tümördür. %35 baş- boyun bölgesi, %40 ekstremite ve diğer alanlar, %25 genitoüriner sistemde izlenir. %5 oranında prostat ve mesanede görülür. Primer prostatik rabdomyosarkom genellikle infant ve çocukluk çağında ortalama 10 yaş civarında izlenir. 20 yaşında sağ-sol yan ağrısı yakınması ile hastanemize başvuran hastanın yapılan tetkikleri sonrası bilateral hidronefroz görüldü. Yapılan üretrografide prostatik üretranın çok daraldığı, sert ve fiske olduğu izlendi ve iğne biyopsi alındı. Mikroskobik incelemede prostat bez yapıları ve fibromüsküler stroması içinde invaziv tümör saptandı. Tümör, oval yuvarlak, yer yer düzensiz kontürlü hiperkromatik nukleusa sahip, arada eozinofilik sitoplâzmalı hücrelerden oluşmaktaydı. Tümör hücreleri immünhistokimyasal yöntemle uygulanan myogenin, desmin, c-kit ile pozitif immünreaksiyon gösterdi. Bu bulgularla olgu embriyonal rabdomyosarkom olarak tanı aldı. Olgu prostatik embriyonel rabdomyosarkomun nadir izlenmesi ve diğer prostatik tümörlerden ayrımı yönünden tartışıldı.

Embryonal Prostatic Rhabdomyosarcoma: A Case Report

Sarcomas account for 0.1 to 0.2% of all prostatic malignancies. Rhabdomyosarcoma is a malignant tumor that shows skeletal muscle (sarcomeric) differentiation. About 35% of rhabdomyosarcomas occur in the head-neck, 40% on the limbs and other areas and 25% in the genitourinary system. Only 5% of them arise in the prostate or bladder. Primary prostatic rhabdomyosarcoma usually develops in infancy and childhood at around 10 years of age. A 20-year-old male presenting with a complaint of right-left side pain was diagnosed with bilateral hydronephrosis after a series of tests. His urethrography showed a severely narrowed, firm and fixed prostatic urethra, so a needle biopsy was performed. The microscopic examination detected an invasive tumor within fibromuscular stroma and prostate glands. The tumor consisted of oval to round tumor cells with hyperchromatic nuclei and irregular contours in places, as well as cells with occasional eosinophilic cytoplasm. Immunohistochemically, the tumor cells showed a positive immunoreaction for myogenin, desmin and c-kit. Based on these findings, the patient was diagnosed with embryonic rhabdomyosarcoma. The case has been presented for discussion, since prostatic embryonic rhabdomyosarcoma is a rare disease with diagnostic challenges in differentiating from other prostatic tumors.

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