The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Sharif, A; Malhotra, NR; Acosta, AM; Kajdacsy-Balla, AA; Bosland, M; Guzman, G; Prins, GS; Abern, MR

Published Date

  • June 2017

Published In

Volume / Issue

  • 77 / 8

Start / End Page

  • 824 - 828

PubMed ID

  • 28191651

Electronic International Standard Serial Number (EISSN)

  • 1097-0045

Digital Object Identifier (DOI)

  • 10.1002/pros.23322


  • eng

Conference Location

  • United States