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CASE REPORT
Year : 2004  |  Volume : 20  |  Issue : 2  |  Page : 167-168
 

Ectopic prostatic tissue presenting as a bladder mass


Department of Urology, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India

Correspondence Address:
V D Trivedi
Department of Urology, Lokmanya Tilak Municipal Medical College and Hospital Sion, Mumbai - 400 022
India
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Source of Support: None, Conflict of Interest: None


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Keywords: Benign prostatic hyperplasia, bladder neoplasm.


How to cite this article:
Trivedi V D, Salve S A, Dangle P, Sawant A, Gadgil, Nelivegi G. Ectopic prostatic tissue presenting as a bladder mass. Indian J Urol 2004;20:167-8

How to cite this URL:
Trivedi V D, Salve S A, Dangle P, Sawant A, Gadgil, Nelivegi G. Ectopic prostatic tissue presenting as a bladder mass. Indian J Urol [serial online] 2004 [cited 2019 Sep 22];20:167-8. Available from: http://www.indianjurol.com/text.asp?2004/20/2/167/21537



   Case Report Top


A 58-year-old farmer presented with profuse hematuria of 3-days' duration. He gave no history of passage of clots or tissue bits, urinary tract infection or lower urinary tract symptom. The patient gave past history of transurethral resection (TUR) of the prostate being done for benign prostatic hyperplasia (BPH) 3 years ago. Examination of the patient was unremarkable with flat normal prostate on per rectal examination. All biochemical investigations including serum prostate specific antigen were within nor­mal limits.

Ultrasonography showed 8 x 6 x 5 cm nodular mass arising from the posterolateral wall of the bladder. Upper tracts were normal. Computed tomography (CT) scan showed the mass to be enhancing and homogenous aris­ing from the left lateral wall with no evidence of nodes [Figure - 1],[Figure - 2]. The patient was taken up for TUR of blad­der tumor with a provisional diagnosis of carcinoma of the bladder. A large nodular mass arising from the left lateral wall of the bladder was noted. The prostate showed minimal lateral lobe enlargement and a TUR biopsy of the mass was taken. The biopsy report revealed BPH with no evidence of any malignancy. Following the report, rest of the mass was resected transurethrally; with uneventful postoperative recovery.


   Comments Top


Ectopic prostatic tissue is very rarely reported. The most common sites found are in the posterior urethra (100 cases), near the verumontanum (12), bulbous urethra (7), bladder (13), posterior to bladder (3) and penile urethra (3). [1]

In the bladder, ectopic prostatic tissue can be found in 2 sites: Sub-cervical glands in the submucosal layer (de­scribed by Albarran) and a deeper group of glands sepa­rated from the submucosal layer by the muscular layer (described by Low sely). [1] Gutierrez and Nesbit [2] proposed 3 possible etiologies for the existence of ectopic tissue.

  1. They could represent structures arising during em­bryonic development and normally undergoing re­gression but are stimulated to grow later in life.
  2. Misplaced nests of prostatic tissue.
  3. Metaplasia of transitional epithelium to glandular epi­thelium occurring as a response to chronic inflam­mation.


Histologically, the glands in ectopic prostatic tissue are distinguished from the normal prostatic tissue by the lack of definitively arranged surrounding connective tissue stroma or muscle fibers but the glands stain positive for acid phosphatase. [2] However, in contrast to the reports in literature, the histopathology of the mass revealed BPH in this case.

This patient presented with hematuria and bladder mass. The presenting symptom of ectopic prostatic tissue almost always is gross painless hematuria, dysuria, frequency and hemospermia. [1] Although an extremely rare possibility, ectopic prostatic tissue can present with painful hematuria. Diagnosis of this condition is possible after histopatho­logical reports are available. Treatment of this lesion is resection and recurrence is rare.

 
   References Top

1.Congleton I, Thomason WB. Painless hematuria and urethral dis­charge secondary to ectopic prostate. J Urol 1989; 142: 1554-5.   Back to cited text no. 1    
2.Gutierrez J, Nesbit RM. Ectopic prostatic tissue in bladder. J Urol 1967; 98: 474-8.  Back to cited text no. 2  [PUBMED]  


    Figures

  [Figure - 1], [Figure - 2]



 

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