A clinical dilemma; single prostatic cancer focus in biopsy. Interpretation and management

Adoption of screening programmes for early diagnosis of prostate cancer has led to an increased number of sonographically guided prostate biopsies. Core needle biopsies are now among the most common specimens received from pathology laboratories. As a result, urologists and pathologists may encounter small volume prostate tumors with obvious clinical and diagnostic implications. These cases may be extremely challenging for two reasons. The diagnosis of small cancer foci is a challenge for pathologists as it carries the risk of false positive or negative diagnosis. Additionally, it represents a difficult clinical dilemma for urologists whether they should proceed or withhold treatment for local disease. This report highlights current concepts regarding pathologic diagnosis and clinical management of these cases.