Ductal adenocarcinoma of the prostate: A clinicopathological study

Objective To study the clinicopathological features of ductal adenocarcinoma of the prostate (DAP).
Materials and method All patients with DAP treated in a single urological unit of a tertiary referral center for a period of 12 years and 4 months from September1996 to December 2008 were analyzed. The median follow up was 78 days (range 20 - 391 days).
Results 16 patients with DAP (pure ductal - 7, mixed ductal-microacinar - 9) were treated during the study period. The median age of the patient was 69 years (range 56=87 years). During the last 33 months of the study period DAP accounted for 7.2% (pure ductal - 3.6%, mixed ductal-microacinar - 3.6%). Of all DAP four patients had haematuria as the presenting symptom. Digital rectal examination revealed a clinically malignant prostate in 13 patients. Serum PSA varied from 3.26 ng/ml to 311 ng/ml. Urethroscopy revealed papillary growths around the verumontanum or inside the prostatic urethra in 6 patients. 4 patients were surgically castrated and one patient received external beam radiation for the control of disease. Watchful waiting was offered for 3 patients.
Conclusion DAP in pure or mixed form accounted for 7.2% of all prostatic carcinomas; 25% of patients presented with haematuria which is an unusual presentation for prostatic microacinar adenocarcinoma.

DOI: 10.4038/slju.v9i1.1959

Sri Lanka Journal of Urology, 2008, 9, 20-24