Prostatic carcinoma, usual variant


  • Acinar adenocarcinoma of the prostate gland is the second most frequently diagnosed form of cancer in the United States. The National Cancer Institute estimates that almost 249,000 new cases will develop in 2021.

Clinical features


  • Prostate cancer is the second leading cause of cancer-related death in men in developing countries.

  • Multiple genetic and environmental factors are involved in prostate carcinogenesis.

  • Age, family history, and race are definitive risk factors.

  • The degree of risk is related to the age and the number of affected relatives, with the greatest risk conferred by a father or brother, with an onset before 40 years of age.

  • Racial background, with American Black people having a higher incidence, higher grade, and more extensive cancer, may be related to different genetic and environmental factors.

  • Dietary fat and sex hormones levels are probable risk factors for prostate carcinoma.

  • Many susceptibility loci and several candidate genes have been identified for hereditary prostate cancer.

  • Linkage analysis has identified few candidate loci for hereditary prostate cancer. Of these, three genes have been cloned: RNaseL on 1q24–25, HPC2 on 17p, and MSR1 on 8p22–23.


  • Most frequently prostate carcinoma is asymptomatic.

  • Approximately 70% of prostate carcinomas arise in the peripheral zone, and some can result in abnormal findings on digital rectal examination.

  • Rarely, prostate carcinoma can lead to urinary obstruction when a large tumor arises in the transition zone, extends into the transition zone from the peripheral zone, or invades the bladder neck.

  • Locally aggressive prostate carcinoma involves the bladder and rectum and can cause hematuria, rectal bleeding, or obstruction.

  • Rarely, patients exhibit symptoms and signs that are related to metastatic prostate carcinoma to different anatomic sites, most commonly the bone, regional lymph nodes, lung, and brain.

  • Currently, most prostate carcinomas are clinically detected by serum PSA screening and digital rectal examination.

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