Author(s): Bikram Rout1, Susanta Meher2, Satyajit Rath3, Rakesh Sharma4, Jayanta Kumar Biswal5, Chandan Kumar Ray Mohapatra6
Incidental Prostatic adenocarcinoma (IPC or Prostatic Incidentalomas) are early stage cancers which are clinically silent and are incidentally diagnosed at histopathological study of operated specimens of benign prostatic disease or screen-detected in asymptomatic individuals. This study investigates the incidence of IPC in operated specimens of patients with benign prostatic hyperplasia and their clinical behaviour. MATERIALS AND METHODS: Operated specimens (both Open Prostatectomy and Transurethral Resection of Prostate [TURP] of all patients with benign prostatic hyperplasia treated in VSS medical college between 2010-2015, were studied prospectively for evidence of IPC on histopathology and the cases were followed up to a period of five years. RESULTS: The incidence of IPC came out to be 6% (12 out of 200 cases). Eight cases (66.67%) were found in the 8th decade. The average IPSS (International Prostate Symptom Score) score of cases with IPC was 18, compared to 13.76 in cases with BPH. All the cases with IPC had a serum PSA (Prostate Specific Antigen) value more than 10ng/ml while, only 10.6% (20 out of 198) of cases with BPH had values more than 10ng/ml. Average weight of the enucleated specimens in cases of IPC was 37gm whereas that of cases with BPH was 44.58gm. Again, the average weight of TURP specimens in cases of IPC was 35 gm whereas that of cases with BPH was 27.88gm. In none of the cases of IPC there was any evidence of local recurrence or metastases during this follow up either clinically or radiologically or by other laboratory investigations. CONCLUSION: A majority of these patients with incidentally diagnosed disease having carcinomatous focus in the enucleated prostate, do not exhibit disease progression and therefore these patients do not necessarily require any specific therapy other than a “wait and watch” policy.