Prostate carcinoma metastatic to the skin as an extrammamary Paget's disease

Diagn Pathol. 2012 Aug 18:7:106. doi: 10.1186/1746-1596-7-106.

Abstract

Aim: The current paper describes a case of prostatic adenocarcinoma metastatic to the skin presenting as an extrammamary Paget's disease, a very rare and poorly characterised morphological entity. We report a case of prostatic carcinoma metastatic to skin showing a pattern of extramammary Paget's disease which has not been clearly illustrated in the literature Case presentation: A 63 year-old man with prostatic adenocarcinoma developed cutaneous metastases after 16 years. The inguinal metastases were sessile and 'keratotic.' The tumour displayed solid, glandular areas as well as a polypoid region suggestive of extramammary Paget's disease were identified.

Discussion and conclusions: We review the diagnostic criteria that have led to the correct histopathological diagnosis in this case. A differential diagnosis of the pagetoid spread in the skin and various forms of cutaneous metastases determined by a prostatic adenocarcinoma as well as the role of immunohistochemistry in establishing the prostatic origin are presented in the context of this case. Although, morphologically the cells presented in the skin deposits were not characteristic for adenocarcinoma of prostate, immunohistochemistry for PSA and PSAP suggested a prostatic origin.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1395450057455276.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / secondary*
  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • Kallikreins / analysis
  • Male
  • Middle Aged
  • Paget Disease, Extramammary / chemistry
  • Paget Disease, Extramammary / pathology*
  • Predictive Value of Tests
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / chemistry
  • Prostatic Neoplasms / pathology*
  • Saposins / analysis
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / secondary*

Substances

  • PSAP protein, human
  • Saposins
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen