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Pseudohyperplastic prostatic carcinoma in simple prostatectomy.

Julián Arista-Nasr¹, Braulio Martinez-Benitez, Jose Antonio Fernandez-Amador

¹Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición S.Z., 14000, México D.F, Mexico.

Annals of Diagnostic Pathology

|March 15, 2011

Summary

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Pseudohyperplastic carcinoma (PHPC), a rare prostate cancer, was found in 1.5% of prostatectomy specimens. Early detection is crucial as PHPC can mimic benign conditions but is potentially aggressive.

Area of Science:

Uropathology
Oncology

Background:

Pseudohyperplastic carcinoma (PHPC) is a rare prostatic neoplasm.
PHPC can be misdiagnosed as benign prostatic hyperplasia or atypical adenomatous hyperplasia.

Observation:

A review of 200 simple prostatectomy specimens identified 3 cases (1.5%) of PHPC.
Tumors were small (4-6 mm), with two initially misdiagnosed as benign.
Histology showed well-differentiated glands mimicking benignity, but cellular atypia and absent basal cells (34BE12 stain) were noted.

Findings:

Immunohistochemistry revealed absence of basal cells (34BE12) and positivity for alpha-methylacyl-CoA-racemase in 2 cases.
One case had adjacent adenocarcinoma, aiding diagnosis.
All 3 patients remained disease-free 3-4 years post-surgery, likely due to small tumor size.

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Implications:

PHPC diagnosis requires careful evaluation, including immunohistochemistry, to differentiate from benign conditions.
Despite small size in this cohort, PHPC is generally considered a moderately differentiated and potentially aggressive neoplasm.
Increased awareness and diagnostic vigilance are necessary for accurate PHPC detection and management.