Incidental Prostate Cancer in Radical Prostatectomy Specimens of Patients Treated for Benign Prostatic Hyperplasia (BPH): Histopathology Analysis

Abstract

Background: The incidence of prostate cancer (Pca) is the first in malignant tumors among men in the United States, and mortality rate is the second cause of deaths. Incidental prostate cancer is defined as clinically inapparent tumor that is neither palpable nor visible by imaging. Incidental carcinoma is found in 3%-16% of pathology specimens of patients undergoing BPH surgery and it involves less than 5% of resected tissue. Aim: To identify incidentally detected prostate cancer in benign prostatic specimens submitted for histopathology Methods: This is a ten-year retrospective histopathology study of all prostate cancer cases diagnosed between 1991-2000 in the department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Haematoxylin & eosin stained histology slides were retrieved and studied. Institution review board (IRB) approval was obtained from the Teaching Hospital to undertake this study. Results: A total of 67 patients had benign prostatic hyperplasia; the patients' age ranged from 30-75 years with a mean age of 52.5 years. The peak age at diagnosis was in the fifth decade. 26 (38.8%) patients had incidental carcinoma. All the tumors were adenocarcinoma and moderately differentiated. Two patients in their fourth decade were found to have incidental prostate cancer. Conclusion: Incidental prostate cancer is common in patients' undergoing radical prostatectomy for BPH, a high index of suspicion, adequate histopathology training and histopathologic evaluation is critical to diagnosis.