Prostatic adenocarcinoma of ductal origin

Clinical and histopathologic features of prostatic ductal adenocarcinomas have been incompletely described. A review of 4,286 cases of prostatic adenocarcinoma (1950 through 1970) at the Mayo Clinic showed 55 cases in which lesions were of a distinctive ductal type. Eight of the 55 lesions originated from periurethral primary prostatic ducts and had exuberant papillary folds. Cystoscopic examination revealed a polypoid and villous or an infiltrative urethral component. The 5-year survival rate (42.8%) was similar to that for the usual acinic adenocarcinomas. Carcinomas originating from secondary ducts had a multi-centric origin and papillary, comedo-like, and cribriform-papillary histopathologic features. The overall 5-year survival rate was 24.2%. Palliative hormone therapy appeared to be less effective in prolonging life in these patients as compared to patients with acinic carcinomas. Bone metastases were osteoblastic, and serum acid phosphatase activities were elevated if metastases were present.