The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?
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.
['Sharif|Asma|A|', 'Malhotra|Neha R|NR|', 'Acosta|Andres M|AM|', 'Kajdacsy-Balla|Andre A|AA|', 'Bosland|Maarten|M|', 'Guzman|Grace|G|', 'Prins|Gail S|GS|', 'Abern|Michael R|MR|']
D000230:Adenocarcinoma D015914:Estrogen Replacement Therapy D004967:Estrogens D005260:Female D006801:Humans D007150:Immunohistochemistry D010535:Laparoscopy D000069451:Long Term Adverse Effects D008297:Male D008875:Middle Aged D060787:Neoplasm Grading D009367:Neoplasm Staging D017430:Prostate-Specific Antigen D011468:Prostatectomy D011471:Prostatic Neoplasms D065287:Robotic Surgical Procedures D057829:Sex Reassignment Procedures D013739:Testosterone D063106:Transgender Persons D016896:Treatment Outcome
prostate adenocarcinoma transgender male to female estrogen testosterone