Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

Abstract

IntroductionTo investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate.MethodsThe clinicopathological and immunohistochemical data of seven patients with ductal adenocarcinoma of the prostate were retrospectively analyzed. All patients underwent physical examination, magnetic resonance imaging (MRI), bone scan, cystoscopy, and computed tomography (CT) scan. The level of prostate-specific antigen (PSA) before and after surgery was assessed. Different prostate cancer markers were used for immunohistochemical staining.ResultsThe mean age of the seven patients diagnosed with prostatic ductal adenocarcinoma in this study was 76.2 years (range 57–88). Five patients presented with intermittent and painless gross hematuria, one patient with progressive dysuria, and one patient with elevated serum PSA on routine health examination. The level of PSA before surgery ranged from 1.3 to 45.0 ng/mL. Immunohistochemical staining results of the prostatic ductal adenocarcinoma confirmed positivity for PSA, prostatic acid phosphatase, androgen receptor, and alpha-methyacyl co-enzyme A (CoA)-reductase markers. Two of the patients underwent bilateral orchiectomy combined with anti-androgen therapy, three underwent transurethral resection of prostate, one received radical prostatectomy, and one received medical castration therapy. The clinical outcomes of all patients were satisfactory, based on follow-up data. The symptoms of hematuria and dysuria were ameliorated well, and the postoperative PSA level decreased below 4.0 ng/mL. Recurrence or metastasis of disease was not detected on MRI and bone scan.ConclusionDuctal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma, the diagnosis of which could be based on pathological and immunohistochemical examination. Earlier management promises better prognosis.

Biomarkers in Urachal Cancer and Adenocarcinomas in the Bladder: A Comprehensive Review Supplemented by Own Data

“…However, this might not be the case for some rare and special differential diagnostic considerations as for example in the discrimination of ductal prostate cancer and the enteric type of urachal adenocarcinomas, in which immunohistochemistry for prostate specific acid phosphatase (PAP) and prostate-specific antigen (PSA) (both negative in urachal adenocarcinomas and positive in ductal prostate cancer) might be useful [ 21 , 27 , 74 , 77 , 100 , 245 , 255 , 357 ].…”

Ability of PITX2 methylation to predict survival in patients with prostate cancer

“…At present, serum prostate-specific antigen testing is the main method used to diagnose prostate cancer in clinical practice. 1 However, elevated serum prostate-specific antigen levels can also reflect pathological changes in other systems, so this test has poor specificity for prostate cancer. There is also no test presently available to predict the aggressiveness of the disease.…”

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

“…Sha et al. [ 16 ] sorely reminded RP could improve the outcomes of DAC with seven patients with no comparison of RT neither. Nevertheless, two of four patients receiving RP in Kan's study had biochemical recurrence 1–2 years post-operation [ 17 ], partly related to delayed diagnosis which meant DAC was more aggressive.…”

“…Thus, it is necessary to further investigate the outcomes of DAC treated with RP or RT. Only few studies reported the outcomes of DAC management with RP or RT with small sample sizes [ [15] , [16] , [17] , [18] , [19] , [20] , [21] ], but failed to compare the efficacy of the two treatments. In addition, most of these studies lacked robust adjustments of confounding factors.…”