Melanoma of the prostate with metastases to lung

Case contributed by A.Prof Frank Gaillard

Presentation

Patient presented with urinary symptoms and retention.

Patient Data

Age: 40
Gender: Male
Modality: Ultrasound

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Case Discussion

Ultrasound of the prostate demonstrates a large irregular prostate, bulging into the base of the bladder, which itself appears thick walled, suggesting hypertrophy. 

CT, performed only with oral contrast (due to renal impairment) confirms the abnormality. The prostatic mass has ill-defined margins with evidence of invasion into the seminal vesicles. Numerous enlarged pelvic nodes are present and both kidneys are hydronephrotic. 

The lungs contain innumerable pulmonary metastases

The appearances are those of a malignant prostatic mass (stage IV). The differential includes advanced prostate cancer, TCC of the bladder base, SCC of the urethra, sarcoma, primary melanoma of the prostate

Histology

Mircoscopic description

The sections show  cores of prostatic  parenchyma infiltrated by a malignant  epithelioid  and spindled  tumour  showing abundant cytoplasmic melanin  pigment,  indicating  a  diagnosis of  melanoma.   Foci  of tumour necrosis are present.

Immunohistochemical stains  have been performed on  this tumour. The tumour cells are positive for  S100, HMB-45 and Melan A,  confirming the diagnosis of melanoma.

Final diagnosis

Prostate TRUS biopsies : melanoma

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Case Information

rID: 11016
Case created: 9th Oct 2010
Last edited: 17th Nov 2015
System: Urogenital
Inclusion in quiz mode: Included

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