Intraductal carcinoma of the prostate (IDC-P) is defined as a proliferation of prostate adenocarcinoma cells distending and spanning the lumen of pre-existing benign prostatic ducts and acini, with at least focal preservation of basal cells. Studies demonstrate that IDC-P is strongly associated with high-grade (Gleason grades 4/5), large-volume invasive prostate cancers. In addition, recent genetic studies indicate that IDC-P represents intraductal spread of invasive carcinoma, rather than a precursor lesion. Some of the architectural patterns in IDC-P exhibit architectural overlap with one of the main differential diagnoses, high-grade prostatic intraepithelial neoplasia (HGPIN). In these instances, additional diagnostic criteria for IDC-P, including marked nuclear pleomorphism, non-focal comedonecrosis (>1 duct showing comedonecrosis), markedly distended normal ducts/acini, positive nuclear staining for ERG, and cytoplasmic loss of PTEN by immunohistochemistry, can help make the distinction. This distinction between IDC-P and HGPIN is of critical importance because IDC-P has an almost constant association with invasive carcinoma and has negative clinical implications, including shorter relapse-free survival, early biochemical relapse, and metastatic failure rate after radiotherapy. Therefore, IDC-P should be reported in prostate biopsies and radical prostatectomies, regardless of the presence of an invasive component. This article will review the history, diagnostic criteria, molecular genetics, and clinical significance of IDC-P.

Citations

Citations to this article as recorded by  

• Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology
  Andrea B. Galosi, Erika Palagonia, Simone Scarcella, Alessia Cimadamore, Vito Lacetera, Rocco F. Delle Fave, Angelo Antezza, Lucio Dell'Atti
  Archivio Italiano di Urologia e Andrologia.2021; 93(1): 92.     CrossRef
• Prostate cancer with comedonecrosis is frequently, but not exclusively, intraductal carcinoma: a need for reappraisal of grading criteria
  Raghav Madan, Mustafa Deebajah, Shaheen Alanee, Nilesh S Gupta, Shannon Carskadon, Nallasivam Palanisamy, Sean R Williamson
  Histopathology.2019; 74(7): 1081.     CrossRef
• The impact of intraductal carcinoma of the prostate on the site and timing of recurrence and cancer‐specific survival
  Vincent Q. Trinh, Jennifer Sirois, Nazim Benzerdjeb, Babak K. Mansoori, Andrée‐Anne Grosset, Roula Albadine, Mathieu Latour, Anne‐Marie Mes‐Masson, Hélène Hovington, Alain Bergeron, Martin Ladouceur, Yves Fradet, Fred Saad, Dominique Trudel
  The Prostate.2018; 78(10): 697.     CrossRef
• Comedonecrosis Revisited
  Samson W. Fine, Hikmat A. Al-Ahmadie, Ying-Bei Chen, Anuradha Gopalan, Satish K. Tickoo, Victor E. Reuter
  American Journal of Surgical Pathology.2018; 42(8): 1036.     CrossRef
• Focal Signet Ring Cell High-Grade Prostatic Intraepithelial Neoplasia on Needle Biopsy
  Guang-Qian Xiao, Pamela D. Unger
  International Journal of Surgical Pathology.2017; 25(4): 344.     CrossRef
• Exposure to maternal obesogenic diet worsens some but not all pre-cancer phenotypes in a murine genetic model of prostate cancer
  Theresa Okeyo-Owuor, Emily Benesh, Scott Bibbey, Michaela Reid, Jacques Halabi, Siobhan Sutcliffe, Kelle Moley, Shree Ram Singh
  PLOS ONE.2017; 12(5): e0175764.     CrossRef
• Histopathological features of intra-ductal carcinoma of prostatic and high grade prostatic intraepithelialneoplasia and correlation with PTEN and P63
  Simin Torabi-Nezhad, Leila Malekmakan, Mohadese Mashayekhi, Arghavan Daneshian
  The Prostate.2016; 76(4): 394.     CrossRef
• Intraduktales Karzinom der Prostata
  G. Kristiansen, M. Varma, G. Seitz
  Der Pathologe.2016; 37(1): 27.     CrossRef
• A Better Understating of the Morphological Features and Molecular Characteristics of Intraductal Carcinoma Helps Clinicians Further Explain Prostate Cancer Aggressiveness
  Rodolfo Montironi, Liang Cheng, Antonio Lopez-Beltran, Marina Scarpelli, Francesco Montorsi
  European Urology.2015; 67(3): 504.     CrossRef
• Clinicopathological analysis of intraductal proliferative lesions of prostate: intraductal carcinoma of prostate, high-grade prostatic intraepithelial neoplasia, and atypical cribriform lesion
  Kosuke Miyai, Mukul K. Divatia, Steven S. Shen, Brian J. Miles, Alberto G. Ayala, Jae Y. Ro
  Human Pathology.2014; 45(8): 1572.     CrossRef