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Prostate Carcinoma
Prostate Carcinoma
• Many men are found to have had incidental microscopic
foci of prostate cancer at postmortem examinati...
Prostate Carcinoma
• 95% of prostate cancers are adenocarcinomas
developing in the acini of prostatic ducts.
Pathology
Prostate Carcinoma
• 70% of cancers occur in the peripheral zone
(PZ), and approximately 20% are found in the
transition z...
Prostate Carcinoma
• Local spread: capsular penetration, invasion of the seminal vesicles, or local
extension along the ne...
Prostate Carcinoma
• Asymptomatic.
• Symptoms of advanced disease with weight loss,
lethargy, bladder outflow obstruction,...
Prostate Carcinoma
• Serum PSA levels increase with age:
PSA
 Patients aged 40-49 years, 0-2.5 ng/mL
 Patients aged 50-5...
Prostate Carcinoma
• Elevated serum PSA levels may also be
associated with prostatitis, prostate infarction,
PIN, prostate...
Prostate Carcinoma
• Serum PSA levels are lowered with finasteride
treatment for benign prostatic hyperplasia
PSA
Prostate Carcinoma
Imaging
Prostate Carcinoma
• Sclerotic metastases or lytic
lesions with bone destruction.
Plain X-Ray
Prostate Carcinoma
• Sclerotic metastases or lytic
lesions with bone destruction.
Plain X-Ray
Prostate Carcinoma
• CT has a limited role in assessing
prostatic cancer, but it may be
helpful in detecting nodal
involve...
Prostate Carcinoma
• CT has a limited role in assessing
prostatic cancer, but it may be
helpful in detecting nodal
involve...
Prostate Carcinoma
• MRI can demonstrate the internal anatomy of the prostate, and it can
identify areas of altered signal...
Prostate Carcinoma
MRI
Prostate Carcinoma
MRI
Prostate Carcinoma
MRI
Prostate Carcinoma
ULTRASOUND
• TRUS plays a central role in the contemporary
diagnosis of prostate cancer because it enab...
Prostate Carcinoma
ULTRASOUND
Hypoechoic area in the PZ.
Prostate Carcinoma
ULTRASOUND
Hypoechoic area in the PZ.
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Prostate carcinoma

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Prostate carcinoma

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Prostate carcinoma

  1. 1. Prostate Carcinoma
  2. 2. Prostate Carcinoma • Many men are found to have had incidental microscopic foci of prostate cancer at postmortem examination, and most prostate cancers are slow growing and do not manifest during the man's lifetime. • Thus, many men die with prostate cancer rather than die from prostate cancer.
  3. 3. Prostate Carcinoma • 95% of prostate cancers are adenocarcinomas developing in the acini of prostatic ducts. Pathology
  4. 4. Prostate Carcinoma • 70% of cancers occur in the peripheral zone (PZ), and approximately 20% are found in the transition zone (TZ). Pathology
  5. 5. Prostate Carcinoma • Local spread: capsular penetration, invasion of the seminal vesicles, or local extension along the neurovascular bundles. • Lymphatic spread: obturator LNs and from there to the common iliac and para-aortic lymph nodes. • Hematogenous spread: bones, and lungs. Skeletal metastases are common in advanced prostate cancer, but hepatic metastases are uncommon. Spread
  6. 6. Prostate Carcinoma • Asymptomatic. • Symptoms of advanced disease with weight loss, lethargy, bladder outflow obstruction, or bone pain. Clinical presentation
  7. 7. Prostate Carcinoma • Serum PSA levels increase with age: PSA  Patients aged 40-49 years, 0-2.5 ng/mL  Patients aged 50-59 years, 0-3.5 ng/mL  Patients aged 60-69 years, 0-4.5 ng/mL  Patients aged 70-79 years, 0-6.5 ng/mL
  8. 8. Prostate Carcinoma • Elevated serum PSA levels may also be associated with prostatitis, prostate infarction, PIN, prostate biopsy, transurethral resection of the prostate, and urethral catheterization. PSA
  9. 9. Prostate Carcinoma • Serum PSA levels are lowered with finasteride treatment for benign prostatic hyperplasia PSA
  10. 10. Prostate Carcinoma Imaging
  11. 11. Prostate Carcinoma • Sclerotic metastases or lytic lesions with bone destruction. Plain X-Ray
  12. 12. Prostate Carcinoma • Sclerotic metastases or lytic lesions with bone destruction. Plain X-Ray
  13. 13. Prostate Carcinoma • CT has a limited role in assessing prostatic cancer, but it may be helpful in detecting nodal involvement and metastases. CT
  14. 14. Prostate Carcinoma • CT has a limited role in assessing prostatic cancer, but it may be helpful in detecting nodal involvement and metastases. CT
  15. 15. Prostate Carcinoma • MRI can demonstrate the internal anatomy of the prostate, and it can identify areas of altered signal intensity, which representing focal pathology in the gland. • MRI is used primarily for staging, but the availability of interventional MRI units means that MRI is likely to have a future role in the diagnosis of prostate cancer. MRI
  16. 16. Prostate Carcinoma MRI
  17. 17. Prostate Carcinoma MRI
  18. 18. Prostate Carcinoma MRI
  19. 19. Prostate Carcinoma ULTRASOUND • TRUS plays a central role in the contemporary diagnosis of prostate cancer because it enables accurate image-guided biopsy of the gland.
  20. 20. Prostate Carcinoma ULTRASOUND Hypoechoic area in the PZ.
  21. 21. Prostate Carcinoma ULTRASOUND Hypoechoic area in the PZ.

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