Intraductal Carcinoma of the Prostate without High-Grade Invasive Adenocarcinoma: Report of Two Cases and Review of the Literature

Arch Esp Urol. 2022 Nov;75(9):738-745. doi: 10.56434/j.arch.esp.urol.20227509.108.

Abstract

Objectives: Intraductal carcinoma of the prostate (IDC-P) is usually associated with high grade, aggresive acinar adenocarcinomas. IDC-P is supposed to result from the spread of the adenocarcinoma along the prostatic ducts. IDC-P rarely occurs without invasive carcinoma or with a coexistent low grade adenocarcinoma.

Material and methods: We report two patients, 66 and 75 year-old, who presented IDC-P and low-grade acinar adenocarcinoma foci in their radical prostatectomy surgical specimens.

Results: Acinar adenocarcinomas were grade group 1, PTEN+, pT2. In the first case, the invasive adenocarcinoma was adjacent but nor intermingled with the IDC-P, and a discordance in the immunophenotype between them was outstanding (positivity for ERG in the acinar carcinoma being negative in the IDC-P). In the second case, the foci of adenocarcinoma were distant from the IDC-P. The first patient had not biochemical recurrence after a 34 month follow-up period.

Conclusions: This kind of cases supports the existence of an infrequent subtype of IDC-P that could be considered as an in situ neoplasia.

Keywords: ERG; adenocarcinoma; intraductal carcinoma; prostate; prostate cancer.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adenocarcinoma* / surgery
  • Aged
  • Carcinoma, Intraductal, Noninfiltrating* / genetics
  • Carcinoma, Intraductal, Noninfiltrating* / pathology
  • Carcinoma, Intraductal, Noninfiltrating* / surgery
  • Humans
  • Male
  • Neoplasm Grading
  • Prostate / pathology
  • Prostatectomy
  • Prostatic Intraepithelial Neoplasia* / genetics
  • Prostatic Intraepithelial Neoplasia* / pathology
  • Prostatic Intraepithelial Neoplasia* / surgery
  • Prostatic Neoplasms* / pathology