title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_190.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Montironi
authors.forename: Marina
authors.initials: M
authors.lastname: Scarpelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Mazzucchelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Lopez-Beltran
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Liang
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000708:Anaplasia / Q000175:diagnosis / Q000473:pathology; D001706:Biopsy; D018267:Carcinoma, Acinar Cell / Q000175:diagnosis* / Q000473:pathology*; D002454:Cell Differentiation; D018450:Disease Progression; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008297:Male; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000473:pathology*; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*