Demonstration of clinicopathological characteristics and clinical significance of rare intraductal prostate carcinoma detected in prostate needle biopsy
Farkas Tamás dr.1, Szabó Balázs dr.1, Tordé Ákos dr.1, Tóth Zoltán dr.1, Salamon Ferenc dr.2
1Uzsoki Utcai Kórház, Urológiai Sebészeti Osztály, Budapest (osztályvezető: Tóth Zoltán dr.)
2Uzsoki Utcai Kórház, Patológia Osztály, Budapest (osztályvezető: Salamon Ferenc dr.)
Introduction: Intraductal carcinoma of the prostate (IDC-P) is a rare entity, which is characterized by prostatic carcinoma involving ducts and acini. This includes two biologically distinct diseases, named IDC-P associated with invasive carcinoma and the more rarely presented pure IDC-P which is a precursor of prostate cancer. Histological differential diagnosis is often challenging and out of atypical cribriform lesions it is crucial to separate it from high grade prostate intraepithelial neoplasia (HGPIN). The presence of IDC-P is associated with large tumour volume, high grade Gleason score and poor prognostic parameters.
Case report: In our case, the histopathological examination revealed pure intraductal carcinoma of the prostate after a transrectal ultrasound (TRUS) guided biopsy. After these findings, we decided to perform rebiopsy.
Conclusions: The proper differential diagnosis has a great clinical significance, because the different entities have different therapeutic and prognostic outcomes. Nevertheless, there is no consensus whether pure IDC-P in the needle biopsies should be managed with rebiopsy or radical treatment. IDC-P often associates with invasive prostate cancer, in other words pure IDC-P without invasive PCa is extremely rare, so the authors have concluded that presence of pure IDC-P in the needle biopsy sample requires close follow-up. A larger prospective study in the future would provide more accurate estimation of the incidence of IDC-P and may help to specify the independent predictive value of IDC-P thus guiding the clinical decision making.