Case ‒ Foamy high-grade prostatic intraepithelial neoplasia: A false positive for prostate cancer on multiparametric magnetic resonance imaging?

  • Thenappan Chandrasekar Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada http://orcid.org/0000-0002-2173-5028
  • Hanan Goldberg Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada
  • Zachary Klaassen Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada
  • Nathan Perlis Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada
  • Antonio Finelli Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada
  • Andrew Evans Department of Pathology, University Health Network, University of Toronto, Ontario, Canada
  • Sangeet Ghai Joint Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada

Abstract

The introduction of multiparametric magnetic resonance imaging (mpMRI) of the prostate, and specifically the introduction of diffusion-weighted imaging (DWI), has significantly impacted the diagnosis of prostate cancer and the management of clinically localized prostate cancer. Indeed, its localizing ability has now opened up opportunities to target focal lesions in partial gland ablation therapy as a treatment option for localized prostate cancer. With negative predictive rates of mpMRI approaching 90% in certain series,1 mpMRI has the ability to discriminate between clinically significant intermediate-to-high-risk prostate cancer and low-risk indolent disease. However, false positives can occur. In recent studies, lesions observed on MRI were classified as tumour on targeted biopsy in 47.6% to over 94% for tumours larger than 0.5 ml in volume.2,3 Herein, we present a case of a rare non-cancer, but putatively pre-malignant prostatic histology that was found on biopsies directed at a category 5 Prostate Imaging Reporting and Data System (PIRADS) v2 lesion.

Author Biography

Thenappan Chandrasekar, Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada

Clinical Fellow

Division of Urologic Oncology, Department of Surgical Oncology, University Health Network, University of Toronto, Ontario, Canada

Published
2018-02-02
How to Cite
Chandrasekar, T., Goldberg, H., Klaassen, Z., Perlis, N., Finelli, A., Evans, A., & Ghai, S. (2018). Case ‒ Foamy high-grade prostatic intraepithelial neoplasia: A false positive for prostate cancer on multiparametric magnetic resonance imaging?. Canadian Urological Association Journal, 12(5), E256-9. https://doi.org/10.5489/cuaj.4860
Section
Residents' Room