Progression from Adenocarcinoma to Small Cell Carcinoma of the Prostate with Normalization of Prostate-Specific Antigen (PSA) Levels

Abstract Background Small cell carcinoma of the prostate is a rare condition with important differences from prostatic adenocarcinoma in terms of clinical and prognostic characteristics. A low prostate-specific antigen and a symptomatic patient, including paraneoplastic symptoms, characterize small cell carcinoma of the prostate. Diagnosis is made on the basis of prostate biopsy, and fluorodeoxyglucose positron emission tomography/computed tomography is often used for staging because up to 60% of patients present with de novo metastatic disease. Patients with metastatic disease are usually treated with platinum-based cytotoxic chemotherapy regimens similar to those used for small cell carcinoma of the lung. However, prognosis remains poor, with a median overall survival of 9 to 17 months despite therapy. Case presentation This report describes a case of an 80-year-old Caucasian patient with lymph node and bone metastatic small cell carcinoma of the prostate following low-dose-rate brachytherapy for a low-risk prostate carcinoma and treated with chemotherapy and immunotherapy. Conclusion Low-dose-rate brachytherapy might be an etiology of small cell prostate cancer.

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Recurrent Prostate Carcinoma Presenting as Omental Large Cell Carcinoma With Neuroendocrine Differentiation and Resulting in Bowel Obstruction

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-1074-rpcpao ◽

2000 ◽

Vol 124 (7) ◽

pp. 1074-1076

Author(s):

San San Wynn ◽

Satyagnani Nagabundi ◽

Jaik Koo ◽

Nena W. Chin

Keyword(s):

Cell Carcinoma ◽

Prostate Specific Antigen ◽

Small Cell Carcinoma ◽

Bowel Obstruction ◽

Metastatic Disease ◽

Specific Antigen ◽

Neuroendocrine Differentiation ◽

Large Cell ◽

Small Cell ◽

Antigen Level

Abstract Neuroendocrine differentiation in the neoplastic prostate varies from foci of adenocarcinoma showing immunoreactivity to the pure small cell carcinoma, which correlates with poor prognosis. Widely metastatic disease in unusual sites is reported for small cell carcinoma, and rarely is the serum prostate-specific antigen level elevated. We report a case of recurrent prostate adenocarcinoma presenting as bowel obstruction due to widespread metastatic disease in the omentum and peritoneum. The histopathology of the omental metastasis was that of a large cell neuroendocrine carcinoma, without evidence of an adenocarcinoma. The absence of a clinically evident second primary tumor, the concomitant elevated serum prostate-specific antigen level, and the positive tissue immunoreactivities to prostatic markers all supported the prostatic origin of the omental tumor. Review of the importance of prostatic neuroendocrine differentiation and its unusual metastatic patterns is presented.

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Brain Metastasis from Prostate Small Cell Carcinoma: Not to be Neglected

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100002250 ◽

2002 ◽

Vol 29 (4) ◽

pp. 375-377 ◽

Cited By ~ 24

Author(s):

Corrie E. Erasmus ◽

Wim I.M. Verhagen ◽

Carla A.P. Wauters ◽

Erik J. van Lindert

Keyword(s):

Brain Metastases ◽

Cell Carcinoma ◽

Prostate Specific Antigen ◽

Small Cell Carcinoma ◽

Prostatic Carcinoma ◽

Right Hemisphere ◽

Prostate Gland ◽

Specific Antigen ◽

Small Cell ◽

The Brain

ABSTRACTBackground:Symptomatic brain metastases from prostatic carcinoma are rare (0.05% to 0.5%).Case report:A 70-year-old man presented with a homonymous hemianopsia due to brain metastatic prostatic carcinoma shortly before becoming symptomatic of prostatic disease. CT and MRI of the brain showed a tumour deep in the right hemisphere near the thalamus and involving the optic radiation.Results:Routine haematological and biochemical tests were normal. The prostate specific antigen level was low on two separate occasions. The prostatic and brain tumours showed identical appearances, namely of a poorly differentiated adenocarcinoma with neuroendocrine differentiation (small cell carcinoma).Conclusion:A literature review suggests that small cell carcinoma of the prostate is more likely to spread to the brain compared to adenocarcinoma and that brain metastases indicate a poor prognosis. The prostate gland should be remembered as a possible cause of brain metastases and that a normal serum prostate specific antigen does not exclude this diagnosis.

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Extensive metastases in prostatic carcinoma with normal prostate-specific antigen and raised carcinoembryonic antigen – Small cell carcinoma of prostate: A rare entity

Indian Journal of Medical and Paediatric Oncology ◽

10.4103/ijmpo.ijmpo_72_17 ◽

2018 ◽

Vol 39 (4) ◽

pp. 539

Author(s):

SanjayMhalasakant Khaladkar ◽

KunaalMahesh Jain ◽

Arijit Ghosh ◽

Rajesh Kuber

Keyword(s):

Cell Carcinoma ◽

Carcinoembryonic Antigen ◽

Prostate Specific Antigen ◽

Small Cell Carcinoma ◽

Prostatic Carcinoma ◽

Specific Antigen ◽

Small Cell ◽

Rare Entity ◽

Normal Prostate

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Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen

Vojnosanitetski pregled ◽

10.2298/vsp181212029v ◽

2020 ◽

Vol 77 (10) ◽

pp. 1101-1103

Author(s):

Sasa Vojinov ◽

Mladen Popov ◽

Ivan Levakov ◽

Aleksandra Levakov-Fejsa ◽

Dimitrije Jeremic ◽

...

Keyword(s):

Prostate Cancer ◽

Cell Carcinoma ◽

Prostate Specific Antigen ◽

Small Cell Carcinoma ◽

Specific Antigen ◽

Small Cell ◽

Histopathological Analysis ◽

Poorly Differentiated Adenocarcinoma ◽

Adenocarcinoma Of The Prostate ◽

Poorly Differentiated

Introduction. Prostate cancer is one of the most common malignancies in men. The most common type is acinar adenocarcinoma. Small cell prostate cancer (SCPC) usually occurs together with coexisting prostate adenocarcinoma. Case report. A 72-years-old patient with voiding simptoms is presented. Initial level of prostate specific antigen (PSA) was 2.87 ng/mL. Twelve prostate biopsies were taken and in six of them neoplastic tissue was detected. The viewed tissue was most convenient to ?small cell carcinoma?. Bone scintigraphy did not demonstrate dissemination of the cancer into the skeletal system. Multislice computed tomography (MSCT) of the pelvis did not reveal any special pathological changes. The patient underwent surgery ? radical retropubical prostatectomy. Histopathological analysis revealed a poorly differentiated adenocarcinoma of the prostate with small cell carcinoma zones [Gleason score 5+5 (10), grade III, pT3bN1, stage IV]. Conclusion. Poorly differentiated adenocarcinoma of the prostate, especially in combination with SCPC, is an aggressive malignancy with most cases presenting with the extensive disease dissemination on diagnosis and poor prognosis. Small cell carcinomas of the prostate are extremely rare tumors of the neuroendocrine origin. Patients with mixed prostate cancer, compared to pure SCPC, have a better prognosis and greater survival rate. There is a lack of the evidence guiding treatment for SCPC.

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370 Pure Primary Small Cell Carcinoma of the Prostate: A Rare Entity

British Journal of Surgery ◽

10.1093/bjs/znab134.549 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

C Desai ◽

A Bhojwani ◽

J Parkin

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Clinical Symptoms ◽

Positive Family History ◽

Malignant Neoplasm ◽

Small Cell ◽

Whole Body ◽

Carcinoma Of The Prostate ◽

Patient Reported ◽

Prostate Cancers

Abstract Introduction We report a case of small cell carcinoma of the prostate (SCCP) which is a rare, high-grade malignant neoplasm accounting for 1% of all prostate cancers (CPa). Case Presentation A 56-year-old male patient initially presented to primary care with a six-month history of frequency, nocturia and pain in the perineal region when seated. A positive family-history for CPa was noted, serum PSA was 11.58, and a rectal examination found a large, irregular mass. He was treated with antibiotics for possible prostatitis and referred to the colorectal team. MRI rectum confirmed a mass between the prostate and rectum, which was found to be pure SCCP on biopsy. Whole-body scanning found multiple lung and pelvic metastases. The patient was commenced on six cycles of Etoposide and Carboplatin therapy. The patient reported that his pelvic discomfort has improved following the first cycle. Conclusions SCCP metastasizes early and therefore the clinical presentation is often in an advanced stage. It is noted that there is limited value of serum PSA for SCCP diagnosis. Instead, pathological examinations and MRI rectum are vital. In terms of treatment, chemotherapy provides relief of the clinical symptoms and its use is in in accordance with the 2016 National Comprehensive Cancer Network guidelines.

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