An 85 year old man underwent Transurethral resection of prostate. A histological examination of his speciman showed foci of adenocarcinoma management will be –
**Core Concept**
The underlying principle being tested is the management of adenocarcinoma of the prostate discovered incidentally after Transurethral Resection of the Prostate (TURP). This involves understanding the **pathophysiology** of prostate cancer and the implications of incidental findings.
**Why the Correct Answer is Right**
The correct management approach depends on the patient's overall health, life expectancy, and the extent of the cancer. Given the patient's age (85 years), the cancer's stage, and grade are crucial in deciding the management plan. Since the question lacks specifics on grade and stage, a general approach would consider the patient's life expectancy and the cancer's potential impact.
**Why Each Wrong Option is Incorrect**
**Option A:** Without specifics on the grade and stage, immediate radical treatment may not be necessary, especially considering the patient's age.
**Option B:** Similar to A, without knowing the specifics, this option might not be universally applicable.
**Option C:** This could be a viable option depending on the cancer's characteristics and the patient's health status, but without specifics, it's hard to judge.
**Option D:** This might be considered in certain cases, especially if the cancer is low-grade and the patient has significant comorbidities.
**Clinical Pearl / High-Yield Fact**
Incidental finding of adenocarcinoma in TURP specimens requires careful consideration of the patient's overall health status, life expectancy, and the tumor's characteristics to decide on the appropriate management strategy. The **Gleason score** is a key factor in determining prognosis and guiding treatment decisions.
**Correct Answer:** D. Active surveillance or watchful waiting may be considered in an 85-year-old patient with incidental finding of adenocarcinoma after TURP, depending on the cancer's characteristics and the patient's health status and preferences.