Type:
Educational Exhibit
Keywords:
Performed at one institution, Observational, Retrospective, Inflammation, Infection, Cancer, Diagnostic procedure, MR-Diffusion/Perfusion, MR, Oncology, Genital / Reproductive system male, Genitourinary
Authors:
S. Durmaz, B. Coskun, T. Gümüs, M. Vural; Istanbul/TR
DOI:
10.26044/ecr2020/C-14763
Background
Patients, who have clinical and laboratory findings suspicious for prostate cancer, routinely undergo mp-MRI instead of biopsy. In these patients, various anatomical structures and benign pathologies include prostatitis, thickening of the surgical capsule, post-biopsy hemorrhage and GP may cause a false-positive result on mp-MRI. GP is one of the best mimickers of prostate cancer(1).
GP is a rare, inflammatory condition that can mimic prostate cancer both clinically and radiologically(2). Oppenheimer et al. (3) reported the incidence of GP is 0,36% in a series of 25.000 men who underwent needle biopsy of the prostate. Although GP has low incidence according to Oppenheimer et al. (3), it is becoming more frequent due to the more widespread use of transurethral resection of the prostate(TUR-P), more extensive prostate biopsies and intravesical Bacillus Calmette-Guerin(BCG) therapy (2).
GP may be classified into; nonspecific, infectious(most commonly BCG therapy-related), iatrogenic(biopsy, TUR-P) or secondary to systemic disease. Nonspecific type is the most common cause of GP (%60-77 of cases), while the iatrogenic type is the second most common(4).
Clinically, the majority of patients are asymptomatic whereas they may present with lower urinary tract symptoms include hematuria or urinary frequency. Serum prostate-specific antigen (PSA) levels are elevated in the majority of cases and it is most affected by acute inflammation. The digital rectal examination is generally suspicious(5).
According to clinical and laboratory findings mentioned above, clinicians often consider prostate adenocarcinoma as a first diagnosis and patients undergo mp-MRI as a first diagnostic tool.