[Metastatic lymph node collision of a prostatic adenocarcinoma and an urothelial carcinoma and review of the literature]

Ann Pathol. 2015 Dec;35(6):496-501. doi: 10.1016/j.annpat.2015.09.005. Epub 2015 Nov 17.
[Article in French]

Abstract

Introduction: Tumor collision is the encounter of two tumors from two different topographical sites. Cases of metastatic lymph node collision are exceptional. We report the case of a metastatic lymph node collision of an urothelial carcinoma and a prostatic adenocarcinoma.

Observation: A 61-year-old man was hospitalized for a right nephroureterectomy with peri-ureteral lymph node dissection. He was followed since 2004 for prostatic adenocarcinoma and treated with radical prostatectomy then radiation therapy 4 years later due to a new increase of PSA. In the follow-up, an urothelial carcinoma of the lower right ureter was discovered in 2014. Histological analysis of a peri-ureteral lymph node showed a double metastasis of urothelial and prostatic origin. The prostatic adenocarcinoma was composed of acinar and ductal subtypes. Immunohistochemical study including CK7, CK20, PSA, GATA3, P63 antibodies confirmed the distinct phenotype of the 2 tumors.

Discussion: Metastatic collision of urothelial carcinoma and prostatic adenocarcinoma has been reported in 4 cases only. Our review of literature shows that prostatic adenocarcinoma always precedes the urothelial carcinoma. Immunohistochemical study, when carried out for distinguishing both tumors, should include CK7, CK20 and PSA. GATA3, androgen receptor and P63 could be added in a second time.

Keywords: Adénocarcinome prostatique; Carcinome urothélial; Collision tumor; Collision tumorale; Ganglion lymphatique; Lymph node; Metastasis; Métastases; Prostatic adenocarcinoma; Urothelial carcinoma.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / secondary*
  • Androgens
  • Biomarkers, Tumor
  • Carcinoma, Transitional Cell / chemistry
  • Carcinoma, Transitional Cell / secondary*
  • Combined Modality Therapy
  • GATA3 Transcription Factor / analysis
  • Humans
  • Keratin-20 / analysis
  • Keratin-7 / analysis
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / pathology*
  • Male
  • Membrane Proteins / analysis
  • Middle Aged
  • Neoplasms, Hormone-Dependent / chemistry
  • Neoplasms, Hormone-Dependent / pathology
  • Neoplasms, Hormone-Dependent / surgery
  • Neoplasms, Second Primary / chemistry
  • Neoplasms, Second Primary / pathology*
  • Prostate-Specific Antigen / analysis
  • Prostatectomy
  • Prostatic Neoplasms / chemistry
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / radiotherapy
  • Prostatic Neoplasms / surgery
  • Radiotherapy, Adjuvant
  • Receptors, Androgen / analysis
  • Ureteral Neoplasms / chemistry
  • Ureteral Neoplasms / pathology*
  • Ureteral Neoplasms / surgery

Substances

  • Androgens
  • Biomarkers, Tumor
  • CKAP4 protein, human
  • GATA3 Transcription Factor
  • GATA3 protein, human
  • Keratin-20
  • Keratin-7
  • Membrane Proteins
  • Receptors, Androgen
  • Prostate-Specific Antigen