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Case Reports
. 2020 Jun 18;3(5):161-165.
doi: 10.1002/iju5.12159. eCollection 2020 Sep.

Microscopic pulmonary tumor embolism from adenocarcinoma of the prostate

Tatsuya Hattori  1 , Yosuke Ikegami  1 , Nayuka Matsuyama  1 , Takashi Hamakawa  1 , Tetsuji Maruyama  2 , Aya Naiki-Ito  3 , Takahiro Yasui  4
Affiliations
Case Reports

Microscopic pulmonary tumor embolism from adenocarcinoma of the prostate

Tatsuya Hattori et al. IJU Case Rep. .

Abstract

Introduction: Microscopic pulmonary tumor embolisms from prostate cancer are extremely rare. In this case of prostate cancer, microscopic pulmonary tumor embolism developed during androgen deprivation therapy.

Case presentation: A 56-year-old man was diagnosed with prostate cancer and underwent androgen deprivation therapy. Three months after starting treatment, he noticed shortness of breath and developed acute progressive dyspnea. He was diagnosed with pulmonary hypertension; however, the cause was not found. His dyspnea was progressive and he died 40 days after the onset of symptoms. Autopsy proved that the cause of pulmonary hypertension was microscopic pulmonary tumor emboli from prostate cancer. Furthermore, histology revealed differences in the androgen receptors in the prostate and emboli, with significantly greater Ki-67 expression in the emboli than in the prostate.

Conclusion: Prostate cancer proliferated in the pulmonary artery after hematogenous metastasis, caused vascular occlusion, and formed microscopic pulmonary tumor embolisms.

Keywords: androgen receptor; cadherin; microscopic pulmonary tumor embolism; prostate cancer; pulmonary hypertension.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Pelvic computed tomography at diagnosis. (a) Sagittal view shows that the tumor has invaded the bladder. (b, c) Horizontal views show metastases to the bilateral lymph nodes and iliac bone.
Fig. 2
Fig. 2
PSMA staining of the cell mass. (a) Hematoxylin and eosin staining and (b) PSMA staining of the pulmonary artery mass. Scale bar is 200 μm.
Fig. 3
Fig. 3
E‐cadherin and N‐cadherin staining. Hematoxylin and eosin staining of (a) the prostate and (b) pulmonary artery; E‐cadherin staining of (c) the prostate and (d) pulmonary artery; N‐cadherin staining of (e) the prostate and (f) pulmonary artery. Scale bar is 200μm.
Fig. 4
Fig. 4
AR and Ki‐67 staining. Hematoxylin and eosin staining of (a) the prostate and (b) pulmonary artery; AR staining of (c) the prostate and (d) pulmonary artery; Ki‐67 staining of (e) the prostate and (f) pulmonary artery. Scale bar is 200 μm.
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