1986 Volume 77 Issue 6 Pages 963-968
The microsections from the 63 consecutive patients upon whom transurethral resection of the prostate gland (TUR-P) was performed at Machida Municipal Hospital, from 1983 through 1985, were the original source of material for study.
Out of 63 cases with preoperative clinical diagnosis of benign prostatic hyperplasia (B. P. H.), 13 cases of incidental adenocarcinoma were found in TUR-P specimens. These 13 cases represent 20.6% of the total number of TUR-P specimens and form the basis of this report.
The patients of B. P. H. and the patients of incidental carcinoma were compared in such clinical features as preoperative serum acid phosphatase values (examined by the method of radioimmunoassay), the mean age of affected patients and the mean weight of resected specimens. But, no significant differences were found between these two groups.
For the purpose of pathological study of incidental carcinoma, we classified cancer according to three pathological factors: the presence of margins of cancer (Circumscribed type), the absence of margins of cancer (under circumscribed type) and the degree of differentiation of the cancer (well differentiated type, moderatelly differentiated type and poorly differentiated type). Out of 13 cases, 6 (46.1%) were circumscribed, 4 (30.8%) under-circumscribed, and 3 (23.1%) mixed. Well differentiated carcinoma was found in 6 (46.1%), moderatelly differentiated in 3 (23.1%), mixed differentated in 3 (23.1%) and poorly differentiated in 1 (7.7%).
For each patient, 108 to 628 (mean 265) resected chips were examined microscopically. Of the 13 patietns with incidental carcinoma, 8 (61.5%) had lesions that were classified as small (under 5 chips) and 5 (38.5%) had lesions that were classified as large (over 6 chips).
Combining the factors of margins of cancer and the spread of cancerous lesions, these 5 patients must be followed up strictly in the clinical course, even though they were the case of incidental prostatic carcinoma.
