BenignEctopic Prostatic Glands in Subvesical Skeletal Muscle.A Lesion Resembling Carcinoma

Overview

In physiological instances, the prostatic acini may be intermingled with striated muscle fibers inthe apex and in the anterolateral subcapsular areas of the prostate. We report an unusual lesioncomposed of benign prostatic glands, which were scattered between skeletal muscle fibers beneath the bladder submucosa. A 55-year - old man underwent four transurethral resections andradiation therapy for a urothelial carcinoma of the urinary bladder. Subsequently a cystectomywas performed. In the resection specimen, the prostate specific antigen-positive glands werefound among the skeletal muscle bundles close to the bladder submucosa. They were seen assmall groups of haphazardly scattered or isolated glands mimicking an infiltrative pattern ofa prostatic adenocarcinoma. Prominent nucleoli in some glands further contributed to the worrisome appearance of the lesion. However, the high molecular weight cytokeratin 34bE12 exhibitedbasal cell layers of the glands, and the subsequent course of disease confirmed the benign natureof the lesion. The juxtaposition of the prostatic acini with the skeletal muscle out of the apex andthe anterolateral subcapsular areas of the prostate should be included in the differential diagnosis of prostatic carcinoma in urinary bladder and prostate biopsies.

Key words:
prostate - prostatic adenocarcinoma - ectopic prostatic glands