Does prostate acinar adenocarcinoma with Gleason Score 3 + 3 = 6 have the potential to metastasize? - Abstract

Background: There is a worldwide debate involving clinicians, uropathologists as well as patients and their families on whether Gleason score 6 adenocarcinoma should be labelled as cancer.

Case description: We report a case of man diagnosed with biopsy Gleason score 6 acinar adenocarcinoma and classified as low risk (based on a PSA of 5 ng/mL and stage cT2a) whose radical prostatectomy specimen initially showed organ confined Gleason score 3+3=6, WHO nuclear grade 3, acinar adenocarcinoma with lymphovascular invasion and secondary deposit in a periprostatic lymph node. When deeper sections were cut to the point that almost all the slice present in the paraffin block was sectioned, a small tumor area (<5% of the whole tumor) of Gleason pattern 4 (poorly formed glands) was found in an extraprostatic position.

Conclusion: The epilogue was that the additional finding changed the final Gleason score to 3+3=6 with tertiary pattern 4 and the stage to pT3a.

Written by:
Montironi R, Scarpelli M, Mazzucchelli R, Lopez-Beltran A, Santoni M, Briganti A, Montorsi F, Cheng L.   Are you the author?
Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Via Conca 71, I − 60126 Torrette, Ancona, Italy.

Reference: Diagn Pathol. 2014 Oct 18;9(1):190.
doi: 10.1186/s13000-014-0190-z

PubMed Abstract
PMID: 25326076 Prostate Cancer Section