Prostate Tumors Overview
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Questions and Answers

What are the three main stages of prostate cancer?

  • In Situ
  • Locally advanced
  • Metastatic
  • All of the above (correct)

    • Prostate cancer is commonly discovered in its early stages.

    False

    Which of the following is NOT a common site of metastasis for prostate cancer?

  • The seminal vescicles
  • The Denonvillier fascia
  • The bladder neck (correct)
  • The lungs

    • What is the most common type of prostatic adenocarcinoma?

    <p>Acinar adenocarcinoma</p> Signup and view all the answers

    What does the Gleason score measure in prostate adenocarcinoma?

    <p>The Gleason score measures the histological differentiation of prostate adenocarcinoma based on the architectural conformation of the tissue.</p> Signup and view all the answers

    Which of the following statements about PSA is TRUE?

    <p>PSA levels can increase in non-cancerous conditions, such as prostatitis.</p> Signup and view all the answers

    Fine needle biopsy is the gold standard for diagnosing prostatic adenocarcinoma.

    <p>True</p> Signup and view all the answers

    What does ISUP stand for?

    <p>International Society of Urological Pathology</p> Signup and view all the answers

    Which of the following is NOT a risk factor for prostate cancer?

    <p>Regular exercise</p> Signup and view all the answers

    Pseudohermaphrodites with a deficiency in 5-alpha reductase can develop prostate cancer.

    <p>False</p> Signup and view all the answers

    Surgical castration can significantly increase the risk of developing prostate cancer.

    <p>False</p> Signup and view all the answers

    Fine needle aspiration is a commonly used method to diagnose prostatic adenocarcinoma.

    <p>False</p> Signup and view all the answers

    Match the following terms with their descriptions:

    <p>ASAP = A histological finding that's not entirely benign, but might be a precursor to prostatic adenocarcinoma ISUP = International Society of Urological Pathology, which developed a classification system to guide pathology assessment PSA = A protein produced by prostate epithelial cells, and is considered a marker for prostate cancer. ROI = A specific region of interest identified in a medical image that warrants further investigation, such as a biopsy</p> Signup and view all the answers

    Why is nerve sparing important during prostate surgery?

    <p>Nerve sparing during prostate surgery is crucial because the nerves control erection and the internal urethral sphincter, and their preservation helps maintain sexual function and urinary continence.</p> Signup and view all the answers

    Explain the difference between intraoperative margin evaluation and postoperative margin evaluation in prostate cancer surgery.

    <p>Intraoperative margin evaluation is performed during surgery to assess the tumor's extent and guide decisions, like whether to perform nerve sparing. Postoperative margin evaluation is done after surgery to analyze the tissue removed to assess if the tumor has been completely resected.</p> Signup and view all the answers

    Which of the following is the correct statement about the anterior zone of the prostate?

    <p>The anterior zone is often neglected in biopsies due to its lower potential for cancer involvement.</p> Signup and view all the answers

    What is the significance of tumor infiltration into the surgical margin in prostate cancer?

    <p>Tumor infiltration into the surgical margin means that the cancer cells have extended beyond the resected tissue, increasing the risk of recurrence and metastasis.</p> Signup and view all the answers

    Mucinous adenocarcinoma is a high-risk type of prostate cancer with a low incidence.

    <p>True</p> Signup and view all the answers

    Which of the following is a characteristic of small neuroendocrine tumors of the prostate?

    <p>They are also known as small cell carcinomas.</p> Signup and view all the answers

    Study Notes

    Prostate Tumors

    • Prostate anatomy is crucial for understanding potential tumors.
    • The prostate can be divided into anterior, posterior, apical, and basal regions.
    • The base of the prostate is near the bladder's inferior surface, while the apex faces the superior fascia of the urogenital diaphragm.
    • The gland is further divided into zones: anterior, transitional, central, and peripheral.
    • Adenocarcinoma frequently arises in the peripheral zone, often in posterior regions of the gland.
    • The Denonvillier fascia is important for surgical procedures involving the prostate and rectum.

    Types of Prostate Tumors

    • Most common is acinar adenocarcinoma (95%).
    • Acinar structures are fundamental units.
    • Ductal adenocarcinoma accounts for 5% of cases.
    • Ductal adenocarcinoma develops in areas between the central and transitional zones, near the urethra.

    Epidemiology

    • Prostate adenocarcinoma is the most common cancer in men globally.
    • Risk factors include both environmental and genetic components.
    • African descent individuals may have a higher susceptibility to the disease.
    • Although the number of prostate cancers remains roughly the same, mortality rates have not significantly changed in recent years.
    • Prostate-specific antigen (PSA) levels increase in cases of prostate cancer.

    Prostate Cancer Diagnosis and Risk Factors

    • Fine-needle biopsy is the standard diagnostic method, emphasizing correct fixation methods.
    • Transurethral resection, performed for BPH, frequently reveals occult adenocarcinomas in 10-16% of cases, especially in the transitional zone.
    • Imaging techniques (ultrasound, magnetic resonance imaging, PET scan) can assist in visualizing relevant regions for biopsy.
    • Previous therapy can alter prostate tissue, so be careful in interpreting pathology results.
    • Patients who have not experienced puberty or who have been castrated are not at risk for prostate cancer.
    • Deficiency in 5-alpha-reductase also prevents prostate cancer development.
    • Surgical castration, estrogenic therapy and anti-androgens reduce prostate cancer risk/occurrence.

    Prostate Cancer Histopathological Features

    • Gleason score is used to grade prostate cancer based on the architectural configuration of the tissue.
    • Various grading methods exist (1966, 2005, 2014 ISUP) -Pattern 3 describes a previously used grouping of Patterns 1 and 2.
    • Gleason score can range from 6 to 10.
    • Gleason Score 3+3 is considered lowest risk. Tumors with a 3+3 Gleason score are in the very first risk group indicated by ISUP classification.
    • Higher Gleason scores indicate more aggressive tumor behaviour.
    • Margin positivity is a strong indicator of poor prognosis.
    • Prognostic parameters include tumor volume, surgical margins, lymphovascular/lymph node involvement and metastasis, which are important factors when considering risk.

    Other Less Common Prostate Cancers

    • Ductal adenocarcinoma, mucinous adenocarcinoma, urothelial carcinoma, neuroendocrine carcinoma, basal cell carcinoma and carcinomas with squamous differentiation are less common, but can be potentially aggressive.
    • Metastases from other organs to the prostate are rare.

    Margin Evaluation

    • Margin evaluation following a biopsy or removal of tumor is important to understand the extent and potential spread of the cancer.
    • Precise localization is important to decide on treatment and prevent recurrence.
    • Risk Factors like Extraprostatic Extension are also taken into account.

    Prognostic Markers

    • Assessing factors like the size of the tumor, the presence of other cancerous cells on any margins and the grading of this tumor are important for effective treatment strategies.

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    Related Documents

    Prostate Tumors Lecture PDF

    Description

    This quiz covers the anatomy, types, and epidemiology of prostate tumors, focusing particularly on acinar adenocarcinoma and its correlation with different prostate zones. Test your knowledge on the critical structures of the prostate and the implications for surgical procedures. Ideal for understanding prostate health and common cancer types in men.

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