DUCTAL (ENDOMETRIOID) ADENOCARCINOMA OF THE PROSTATE - A CLINICOPATHOLOGICAL STUDY OF 16 CASES

Sixteen cases of ductal (endometrioid) carcinoma of the prostate are p resented. The tumour presents in elderly men (age range 65-87 years) w ith haematuria or obstructive symptoms. Serum prostate specific antige n may be normal or raised. On cytoscopy, there is often an exophytic l esion in the region of the verumontanum Histologically, two variants a re recognized: papillary and cribriform, of which there were eight cas es each. Eight cases consisted of pure ductal carcinoma and seven were mixed, containing a variable proportion of micro-acinar carcinoma. Th e associated micro-acinar carcinoma had a Gleason score of at least 5. One case of carcinosarcoma with a ductal epithelial component was als o included. All cases displayed positive immunohistochemical staining for prostate specific antigen and prostatic acid phosphatase and but w ere negative for the basal cell marker MA903. The tumour responds well to orthodox micro-acinar carcinoma therapy and appears notably sensit ive to hormonal manipulation. Follow-up of the mixed group is restrict ed to a maximum of 3 years. Of the eight pure cases, five patients are still alive with survival periods of 11, 8, 7, 3 and 1 years. Three p atients died of intercurrent disease of which one patient survived 12 years, having received no treatment. This tumour, therefore, can be re garded as having a good prognosis.