Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Diagnostic Pathology
Published in: Diagnostic Pathology 1/2012

Open Access 01-12-2012 | Case Report

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

Authors: Eugen Bogdan Petcu, Aldo Gonzalez-Serva, Robert G Wright, Mark Slevin, Klara Brinzaniuc

Published in: Diagnostic Pathology | Issue 1/2012

Login to get access

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.​diagnosticpathol​ogy.​diagnomx.​eu/​vs/​1395450057455276​
Appendix
Available only for authorised users
Literature
1.
Bassett JK, Severi G, Hodge AM, Baglietto L, Hopper JL, English DR, Giles GG: Dietary intake of B vitamins and methionine and prostate cancer incidence and mortality. Cancer Causes Control. 2012, 23 (6): 855-863. 10.1007/s10552-012-9954-5.CrossRefPubMed
2.
Venable DD, Hastings D, Misra RP: Unusual metastatic patterns of prostate adenocarcinoma. J Urol. 1983, 130 (5): 980-985.PubMed
3.
Paner GP, Luthringer DJ, Amin MB: Best practice in diagnostic immunohistochemistry: prostate carcinoma and its mimics in needle core biopsies. Arch Pathol Lab Med. 2008, 132 (9): 1388-1396.PubMed
4.
Gates O: Cutaneous metastases of malignant disease. Am J Cancer. 1937, 30: 718-730.
5.
Landow RK, Rhodes DW, Bauer M: Cutaneous metastases. Report of two cases of prostatic cancer. Cutis. 1980, 26 (4): 399-401. 409PubMed
6.
Lookingbill DP, Spangler N, Helm KF: Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol. 1993, 29 (2 Pt 1): 228-236.CrossRefPubMed
7.
Powell FC, Venencie PY, Winkelmann RK: Metastatic prostate carcinoma manifesting as penile nodules. Arch Dermatol. 1984, 20 (12): 1604-1606.CrossRef
8.
Rattanasirivilai A, Kurban A, Lenzy YM, Yaar R: Cutaneous metastasis of prostatic adenocarcinoma: a cautionary tale. J Cutan Pathol. 2011, 38 (6): 521-524. 10.1111/j.1600-0560.2011.01677.x.CrossRefPubMed
9.
Kremer V, Kremer A, Baldwin K, Sirsi S, Rafiaa A: Metastatic prostate carcinoma mimicking primary anal cancer. Urology. 2012, 79 (5): e75-e76. 10.1016/j.urology.2011.09.033. Epub 2011, Nov 16CrossRefPubMed
10.
Collina G, Reggiani C, Carboni G: Ductal carcinoma of the prostate metastatic to the skin. Pathologica. 2011, 103 (2): 50-51.PubMed
11.
Abrol N, Seth A, Chattergee P: Cutaneous metastasis of prostate carcinoma to neck and upper chest. Indian J Pathol Microbiol. 2011, 54 (2): 394-395. 10.4103/0377-4929.81644.CrossRefPubMed
12.
López-Navarro N, López-Sánchez JC, Pérez-Enríquez JE, Bosch RJ, Herrera E: Atypical skin metastases of mucinous adenocarcinoma of the prostate with signet ring cells. Actas Dermosifiliogr. 2009, 100 (4): 338-341. 10.1016/S0001-7310(09)70835-X.CrossRefPubMed
13.
Reddy S, Bang RH, Contreras ME: Telangiectatic cutaneous metastasis from carcinoma of the prostate. Br J Dermatol. 2007, 156 (3): 598-600. 10.1111/j.1365-2133.2006.07696.x.CrossRefPubMed
14.
Boswell JS, Davis MD: Violaceous plaque on the forehead clinically resembling angiosarcoma: cutaneous metastasis in a patient with prostatic adenocarcinoma. J Am Acad Dermatol. 2005, 53 (4): 744-745. 10.1016/j.jaad.2005.04.047.CrossRefPubMed
15.
Segal R, Penneys NS, Nahass G: Metastatic prostatic carcinoma histologically mimicking malignant melanoma. J Cutan Pathol. 1994, 21 (3): 280-282. 10.1111/j.1600-0560.1994.tb00274.x.CrossRefPubMed
16.
Yildirim Y, Akcay Y, Ozyilkan O, Celasun B: Prostate small cell carcinoma and skin metastases: a rare entity. Med Princ Pract. 2008, 17 (3): 250-252. 10.1159/000117801. Epub 2008 Apr 10CrossRefPubMed
17.
18.
van der Putte SC, Toonstra J, Hennipman A: Mammary Paget's disease confined to the areola and associated with multifocal Toker cell hyperplasia. Am J Dermatopathol. 1995, 17 (5): 487-493. 10.1097/00000372-199510000-00010.CrossRefPubMed
19.
Haupt HM, Stern JB: Pagetoid melanocytosis. Histologic features in benign and malignant lesions. Am J Surg Pathol. 1995, 19 (7): 792-797. 10.1097/00000478-199507000-00007.CrossRefPubMed
20.
Tannous ZS, Lerner LH, Duncan LM, Mihm MC, Flotte TJ: Progression to invasive melanoma from malignant melanoma in situ, lentigo maligna type. Hum Pathol. 2000, 31 (6): 705-708. 10.1053/hupa.2000.7640.CrossRefPubMed
21.
Busam KJ, Barnhill RL: Pagetoid Spitz nevus. Intraepidermal Spitz tumor with prominent pagetoid spread. Am J Surg Pathol. 1995, 19 (9): 1061-1067. 10.1097/00000478-199509000-00010.CrossRefPubMed
22.
Boyd AS, Rapini RP: Acral melanocytic neoplasms: a histologic analysis of 158 lesions. J Am Acad Dermatol. 1994, 31 (5 Pt 1): 740-745.CrossRefPubMed
23.
Williamson JD, Colome MI, Sahin A, Ayala AG, Medeiros LJ: Pagetoid bowen disease: a report of 2 cases that express cytokeratin 7. Arch Pathol Lab Med. 2000, 124 (3): 427-430.PubMed
24.
Nguyen GK, Mielke BW: Extraocular sebaceous carcinoma with intraepidermal (pagetoid) spread. Am J Dermatopathol. 1987, 9 (4): 364-365.CrossRefPubMed
25.
Oka K, Katsumata M: Intraepidermal sebaceous carcinoma: case report. Dermatologica. 1990, 180 (3): 181-185. 10.1159/000248026.CrossRefPubMed
26.
Russell WG, Page DL, Hough AJ, Rogers LW: Sebaceous carcinoma of meibomian gland origin. The diagnostic importance of pagetoid spread of neoplastic cells. Am J Clin Pathol. 1980, 73 (4): 504-511.PubMed
27.
Rao NA, Hidayat AA, McLean IW, Zimmerman LE: Sebaceous carcinomas of the ocular adnexa: A clinicopathologic study of 104 cases, with five-year follow-up data. Hum Pathol. 1982, 13 (2): 113-122. 10.1016/S0046-8177(82)80115-9.CrossRefPubMed
28.
Brown HA, Sawyer DM, Woo T: Intraepidermal Merkel cell carcinoma with no dermal involvement. Am J Dermatopathol. 2000, 22 (1): 65-69. 10.1097/00000372-200002000-00013.CrossRefPubMed
29.
Swanson PE, Marrogi AJ, Williams DJ, Cherwitz DL, Wick MR: Tricholemmal carcinoma: clinicopathologic study of 10 cases. J Cutan Pathol. 1992, 19 (2): 100-109. 10.1111/j.1600-0560.1992.tb01350.x.CrossRefPubMed
30.
Blandamura S, Altavilla G, Antonini C, Marchetti M, Piazza M: Porocarcinoma detected by fine needle aspiration biopsy of a node metastasis. A case report. Acta Cytol. 1997, 41 (4 Suppl): 1305-1309.CrossRefPubMed
31.
Starink TM, Blomjous CE, Stoof TJ, Van Der Linden JC: Clear cell basal cell carcinoma. Histopathology. 1990, 17 (5): 401-405. 10.1111/j.1365-2559.1990.tb00759.x.CrossRefPubMed
32.
Roten SV, Bhawan J: Isolated dyskeratotic acanthoma. A variant of isolated epidermolytic acanthoma. Am J Dermatopathol. 1995, 17 (1): 63-66. 10.1097/00000372-199502000-00012.CrossRefPubMed
33.
Piérard-Franchimont C, Dosal FL, Estrada JA, Piérard GE: Cutaneous hamartoma with pagetoid cells. Am J Dermatopathol. 1991, 13 (2): 158-161. 10.1097/00000372-199104000-00009.CrossRefPubMed
34.
Kuo TT, Chan HL, Hsueh S: Clear cell papulosis of the skin. A new entity with histogenetic implications for cutaneous Paget's disease. Am J Surg Pathol. 1987, 11 (11): 827-834. 10.1097/00000478-198711000-00001.CrossRefPubMed
35.
Lee JY, Chao SC: Clear cell papulosis of the skin. Br J Dermatol. 1998, 138 (4): 678-683. 10.1046/j.1365-2133.1998.02185.x.CrossRefPubMed
36.
Val-Bernal JF, Garijo MF: Pagetoid dyskeratosis of the prepuce. An incidental histologic finding resembling extramammary Paget's disease. J Cutan Pathol. 2000, 27 (8): 387-391. 10.1034/j.1600-0560.2000.027008387.x.CrossRefPubMed
37.
Val-Bernal JF, Hernández-Nieto E: Benign mucinous metaplasia of the penis. A lesion resembling extramammary Paget's disease. J Cutan Pathol. 2000, 27 (2): 76-79. 10.1034/j.1600-0560.2000.027002076.x.CrossRefPubMed
38.
Toker C: Clear cells of the nipple epidermis. Cancer. 1970, 25 (3): 601-610. 10.1002/1097-0142(197003)25:3<601::AID-CNCR2820250315>3.0.CO;2-I.CrossRefPubMed
39.
Lundquist K, Kohler S, Rouse RV: Intraepidermal cytokeratin 7 expression is not restricted to Paget cells but is also seen in Toker cells and Merkel cells. Am J Surg Pathol. 1999, 23 (2): 212-219. 10.1097/00000478-199902000-00011.CrossRefPubMed
40.
Ioannides G, Engel MF, Rywlin AM: Woringer-Kolopp disease (pagetoid reticulosis). Am J Dermatopathol. 1983, 5 (2): 153-158. 10.1097/00000372-198304000-00013.CrossRefPubMed
41.
Luther H, Bacharach-Buhles M, Schultz-Ehrenburg U, Altmeyer P: Pagetoid reticulosis of the Ketron-Goodman type. Hautarzt. 1989, 40 (8): 530-535.PubMed
42.
Hashimoto K, Schachner LA, Huneiti A, Tanaka K: Pagetoid self-healing Langerhans cell histiocytosis in an infant. Pediatr Dermatol. 1999, 16 (2): 121-127. 10.1046/j.1525-1470.1999.00029.x.CrossRefPubMed
43.
Wood C, Wood GS, Deneau DG, Oseroff A, Beckstead JH, Malin J: Malignant histiocytosis X. Report of a rapidly fatal case in an elderly man. Cancer. 1984, 54 (2): 347-352. 10.1002/1097-0142(19840715)54:2<347::AID-CNCR2820540228>3.0.CO;2-J.CrossRefPubMed
44.
Nofal A, Assaf M, Tawfik A, Elsayed N, Nofal E, Elnakib N, Elmosalamy K: Progressive nodular histiocytosis: a case report and literature review. Int J Dermatol. 2011, 50 (12): 1546-1551. 10.1111/j.1365-4632.2011.04904.x.CrossRefPubMed
45.
Grob JJ, Gabriel B, Horchowski N, Bonerandi JJ: Bullous cutaneous localization with epidermotropism in monoblastic leukemia. Ann Dermatol Venereol. 1988, 115 (1): 59-61.PubMed
46.
Reedy MB, Morales CA, Moliver CL, Dudrey EF, Boman DA: Paget's disease of the scrotum: a case report and review of current literature. Tex Med. 1991, 87 (10): 77-79.PubMed
47.
Jones RE, Austin C, Ackerman AB: Extramammary Paget's disease. A critical reexamination. Am J Dermatopathol. 1979, 1 (2): 101-132. 10.1097/00000372-197900120-00002.CrossRefPubMed
48.
Kobashi-Katoh R, Tanioka M, Takahashi K, Miyachi Y: Skin metastasis of prostate adenocarcinoma to glans penis showing no correlation with serum prostate-specific antigen level. J Dermatol. 2009, 36 (2): 106-108. 10.1111/j.1346-8138.2009.00599.x.CrossRefPubMed
49.
Varma: Diagnostic utility of immunohistochemistry in morphologically difficult prostate cancer: review of current literature. Histopath. 2005, 47 (1): 1-16. 10.1111/j.1365-2559.2005.02188.x.CrossRef
50.
Srinivasan M, Parwani AV: Diagnostic utility of p63/P501S double sequential immunohistochemical staining in differentiating urothelial carcinoma from prostate carcinoma. Diagnostic Pathology. 2011, 6: 67-10.1186/1746-1596-6-67.PubMedCentralCrossRefPubMed
51.
52.
Moore MW, Gasparini R: FISH as an effective diagnostic tool for the management of challenging melanocytic lesions. Diagnostic Pathology. 2011, 6: 76-10.1186/1746-1596-6-76.PubMedCentralCrossRefPubMed
53.
Taylor BS, Schultz N, Hieronymus H, Gopalan A, Xiao Y, Carver BS, Arora VK, Kaushik P, Cerami E, Reva B, Antipin Y, Mitsiades N, Landers T, Dolgalev I, Major JE, Wilson M, Socci ND, Lash AE, Heguy A, Eastham JA, Scher HI, Reuter VE, Scardino PT, Sander C, Sawyers CL, Gerald WL: Integrative genomic profiling of human prostate cancer. Cancer Cell. 2010, 18 (1): 11-22. 10.1016/j.ccr.2010.05.026. Epub 2010 Jun 24PubMedCentralCrossRefPubMed
Metadata
Title
Prostate carcinoma metastatic to the skin as an extrammamary Paget’s disease
Authors
Eugen Bogdan Petcu
Aldo Gonzalez-Serva
Robert G Wright
Mark Slevin
Klara Brinzaniuc
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2012
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/1746-1596-7-106

Other articles of this Issue 1/2012

Diagnostic Pathology 1/2012 Go to the issue

Research

Oncogenic reg IV is a novel prognostic marker for glioma patient survival

Case Report

Primary splenic histiocytic sarcoma complicated with prolonged idiopathic thrombocytopenia and secondary bone marrow involvement: a unique surgical case presenting with splenomegaly but non-nodular lesions

Research

Local distribution analysis of cytotoxic molecules in liver allograft is helpful for the diagnosis of acute cellular rejection after orthotopic liver transplantation

Research

LMP1 and LMP2A are potential prognostic markers of extranodal NK/T-cell lymphoma, nasal type (ENKTL)

Case Report

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

Research

The Intrahepatic Expression and Distribution of BTLA and its Ligand HVEM in patients with HBV-related acute-on-chronic liver failure