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How Does One Know If The Cancer Has Spread As Prostate Metastasis While Having Low-density Liver Lesions?
Sections from the entirely submitted Right Prostate Core Biopsy are reviewed on one H&E stained slide and one immunohistochemical stained slide including positive and negative controls. The sections show foci of prostatic adenocarcinoma with Gleason score 3+3=6cores. The foci of adenocarcinoma involves 10% of the submitted tissue and are highlighted by immunohistochemical PIN cocktail with positive Racemace (+0and negative P63(-) High grade prostatic intraepithelial neoplasia is also present,. There is no extraprostatic involvement or perineural invasion seen. Sections for the entirely submitted Left Prostate core Biopsy are viewed on one H&E stained slide and one immunohistochemical stained slide including positive and negative controls. The sections show two small foci of prostatic glandular epithelium with cribriforming th foci of atypicia glands involvesless tha 1% of the submitted tissue and are highlighted by immunohistochemical PIN cocktail with positive reacemace(+) and negative P63(-) .(LL/r) With these findings and an multiple low-density liver lesions may represent prostate metastasis what is your opinion that the cancer has spread?
Fri, 30 Dec 2022
Hello,
The findings mentioned in the above report clearly state that the person has Prostate cancer adenocarcinoma. Prostate cancer is treated based on risk stratification for which we need the extent of disease and the level of PSA. Stage is difficult to say but considering that both side of prostate are involved it seems to be at least Stage II.
Now the liver lesions you mention to be low density I assume are on CT scan. Having multiple low density liver lesion is not a clear indicator of metastasis. Mostly the liver lesion will have to be separately biopsied to get to know in detail. More information like PSA level would tell us if there is high chance of metastasis or not. Considering that there is no extra prostatic involvement and no perineural invasion it would be less likely to be metastatic.
But only after knowing further details like PSA and biopsy from liver lesion or at least seeing the scan can one be sure of whether or not the prostatic cancer has spread. Some doctors may even get a PSMA PET scan done to rule out metastasis if highly suspicious. Only based on the above information difficult to predict whether the low density liver lesions are metastasis or not.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Shreya Kunder, General & Family Physician
The findings mentioned in the above report clearly state that the person has Prostate cancer adenocarcinoma. Prostate cancer is treated based on risk stratification for which we need the extent of disease and the level of PSA. Stage is difficult to say but considering that both side of prostate are involved it seems to be at least Stage II.
Now the liver lesions you mention to be low density I assume are on CT scan. Having multiple low density liver lesion is not a clear indicator of metastasis. Mostly the liver lesion will have to be separately biopsied to get to know in detail. More information like PSA level would tell us if there is high chance of metastasis or not. Considering that there is no extra prostatic involvement and no perineural invasion it would be less likely to be metastatic.
But only after knowing further details like PSA and biopsy from liver lesion or at least seeing the scan can one be sure of whether or not the prostatic cancer has spread. Some doctors may even get a PSMA PET scan done to rule out metastasis if highly suspicious. Only based on the above information difficult to predict whether the low density liver lesions are metastasis or not.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Shreya Kunder, General & Family Physician
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