Premium
The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?
Author(s) -
Sharif Asma,
Malhotra Neha R.,
Acosta Andres M.,
KajdacsyBalla Andre A.,
Bosland Maarten,
Guzman Grace,
Prins Gail S.,
Abern Michael R.
Publication year - 2017
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23322
Subject(s) - prostate cancer , medicine , prostate , androgen receptor , estrogen , estrogen receptor , population , gender dysphoria , transgender , immunohistochemistry , oncology , cancer , breast cancer , psychology , environmental health , psychoanalysis
BACKGROUND Prostate adenocarcinoma (PCa) is a rare diagnosis in the male to female transgender (MtFT) population with only a few case reports published in the current medical literature. Long standing beliefs of androgen suppression conferring a protective effect against prostate cancer development have been challenged by the literature citing adenocarcinoma development in the prostate of rodent models following combined estrogen and testosterone treatment. MATERIALS AND METHODS We herein present a MtFT patient who presented with high grade PCa following 20 years of exogenous estrogen therapy. RESULTS Immunohistochemical (IHC) localization of estrogen receptor alpha (ER‐α) and progesterone receptor (PR) demonstrated positive staining in stromal cells; while, androgen receptor (AR) demonstrated positive staining in malignant glands and weak scattered staining in adjacent stroma. CONCLUSION This pattern of staining raises concern for a possible contributing role of exogenous estrogen therapy in tumorigenesis. As awareness of gender dysphoria and acceptance of gender reassignment surgery has seen a recent increase, the unique needs of this population must be recognized. Prostate 77:824–828, 2017 . © 2017 Wiley Periodicals, Inc.