scholarly journals Case Report: Systemic Treatment and Serial Genomic Sequencing of Metastatic Prostate Adenocarcinoma Progressing to Small Cell Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
XiaoJun Lu ◽  
Wenwen Gao ◽  
Yu Zhang ◽  
Tao Wang ◽  
Hongliang Gao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cell Carcinoma ◽  
Seminal Vesicle ◽  
Small Cell Carcinoma ◽  
Cell Cancer ◽  
Phylogenetic Reconstruction ◽  
Neuroendocrine Differentiation ◽  
Small Cell ◽  
Castration Resistance ◽  
Tumor Biopsy

Small cell carcinoma (SCC)/neuroendocrine prostate cancer (NEPC) is a rare and highly aggressive subtype of prostate cancer associated with an AR(androgen receptor)-null phenotype and visceral metastases. This study presents a 44-year-old man originally diagnosed with metastatic hormone-sensitive prostatic adenocarcinoma. After 6-month androgen deprivation therapy (ADT) combined with docetaxel, the patient developed paraplegia. Laminectomy was performed, and a thoracic vertebral biopsy revealed neuroendocrine differentiation and mixed adenocarcinoma. The patient developed liver metastases and experienced stable disease for 4 months following etoposide combined with cisplatin and pembrolizumab. Seminal vesicle biopsy after chemotherapy revealed small-cell cancer. The prostate biopsy specimen also indicated pure SCC. We witnessed the dynamic evolution from pure adenocarcinoma to fully differentiated SCC, leading to obstruction and death. In addition, whole-exome sequencing was performed on both biopsy specimens of the thoracic vertebra at the beginning of castration resistance and that of seminal vesicle after multiple lines of treatment failure. Utilizing phylogenetic reconstruction, we observed that both samples shared a common ancestor clone harboring aberrations in the TP53, RB1, and NF2 genes. We also discovered that driver events in the private subclones of both samples, such as alterations in CDC27 and RUNX1, might have played a significant role in tumor progression or even neuroendocrine differentiation. Tumor biopsy and IHC assessment must be repeated at different stages of progression, because of intrapatient spatial and temporal heterogeneity of adenocarcinoma versus SCC/NEPC. Although, typical treatments including ADT, docetaxel, etoposide, cisplatin, and pembrolizumab provided temporary response, the patient still had a poor prognosis.

scholarly journals Small Cell Carcinoma of the Prostate in an Elderly Patient: A Case Report and Review of the Literature

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 176-178 ◽  
Author(s):  
Dale Alan Whitaker ◽  
Daniel H. Miller ◽  
Niveditha Jagadesh ◽  
Gerald W. Strong ◽  
Lauren Hintenlang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Current Knowledge ◽  
Case Reports ◽  
The United States ◽  
Small Cell ◽  
Rapid Progression ◽  
Retrospective Case

Prostate cancer is the most common malignancy of men in the United States. Small-cell carcinoma (SCC), which typically presents as an aggressive lung malignancy, is a rare diagnosis within the setting of prostate cancer pathology. Due to its limited prevalence, little information regarding the treatment and prognosis of this disease in large populations is available. To date our current knowledge base is largely limited to case reports and retrospective case reviews. The mainstay of treatment for this particular histology most often involves a multimodality approach utilizing chemotherapy in conjunction with radiation therapy, androgen deprivation therapy, or prostatectomy. Here we present the case of an elderly 89-year-old Caucasian male who was diagnosed with SCC of the prostate. Despite proceeding with a course of definitive radiotherapy, the patient experienced rapid progression of disease and ultimately elected to discontinue radiation therapy and receive hospice care.

Mechanisms of Neuroendocrine Differentiation in Pulmonary Neuroendocrine Cells and Small Cell Carcinoma

2003 ◽  
Vol 14 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Takaaki Ito ◽  
Naoko Udaka ◽  
Kohji Okudela ◽  
Takuya Yazawa ◽  
Hitoshi Kitamura
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Neuroendocrine Differentiation ◽  
Small Cell ◽  
Neuroendocrine Cells ◽  
Pulmonary Neuroendocrine Cells

scholarly journals Malignant Melanoma With Neuroendocrine Differentiation: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Jason Cham ◽  
Ayal Shavit ◽  
Aren Ebrahimi ◽  
Miguel Viray ◽  
Paul Gibbs ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Neuroendocrine Differentiation ◽  
Small Cell ◽  
Brown Pigment ◽  
Molecular Testing ◽  
Lung Mass ◽  
Diagnostic Uncertainty ◽  
Wide Range ◽  
Microscopic Morphology

BackgroundMelanoma has a wide range of histologic variants and cytomorphologic features that make its diagnosis challenging. Melanoma can also rarely have neuroendocrine markers adding further diagnostic uncertainty particularly given that unrelated tumor types, such as prostate cancer, can also display focal neuroendocrine differentiations.Case presentationOur patient is a 74-year-old Caucasian man found to have a lung mass. Initial biopsy revealed typical microscopic morphology and neuroendocrine differentiation consistent with small cell carcinoma. Despite standard chemoradiation treatment, the patient continued to progress with new metastasis in the brain, liver and bone. Subsequent chest wall biopsy revealed golden-brown pigment associated with melanin. Further tumor immunohistochemistry revealed extensive neuroendocrine differentiation with CD56, synaptophysin, and INSM1, as well as strong immunoreactivity for melanocyte markers including SOX10, S100, PRAME, and MITF, consistent with metastatic melanoma with neuroendocrine differentiation. Genomic testing revealed increased tumor mutational burden and alterations in NF1, BRAF, CDKN2A/B, TERT. The patient was transitioned to checkpoint inhibitor therapy with nivolumab and ipilimumab and had resolution of his intracranial mass and decrease in size of other metastatic lesions.ConclusionOften the combination of anatomic findings such as a lung mass, typical microscopic morphology, and confirmation of neuroendocrine differentiation correctly identifies a patient with small cell carcinoma. However, in a patient who fails to respond to treatment, a broader immunohistochemical workup along with molecular testing with additional tissue may be warranted.

scholarly journals Immune Exclusion Is Frequent in Small-Cell Carcinoma of the Bladder

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Tim Mandelkow ◽  
Niclas C. Blessin ◽  
Eva Lueerss ◽  
Laura Pott ◽  
Ronald Simon ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cell Carcinoma ◽  
Cell Density ◽  
Small Cell Carcinoma ◽  
Immune Cell ◽  
Cell Cancer ◽  
Small Cell ◽  
Urothelial Carcinomas ◽  
Significant Difference ◽  
Cell Bladder Cancer

Small-cell cancer of the urinary bladder is a rare but highly aggressive disease. It is currently unclear whether immune checkpoint therapies that have been approved for urothelial carcinomas will also be efficient in small-cell carcinomas. In this study, we analyzed potential predictors of response including PD-L1 expression and the quantity and location of tumor-infiltrating lymphocytes (TILs) in 12 small-cell and 69 “classical” urothelial cancers by immunohistochemistry. The analysis revealed that small-cell carcinomas were characterized by the virtual absence of PD-L1 expression and an “immune-excluded” phenotype with only a few TILs in the center of the tumor (CT). In small-cell carcinomas, the average immune cell density in the CT (CD3: 159±206, CD8: 87±169 cells/mm2) was more than 3 times lower than that in the urothelial carcinomas (CD3: 625±800, p<0.001; CD8: 362±626 cells/mm2, p=0.004) while there was no significant difference in the immune cell density at the invasive margin (IM) (small-cell carcinomas CD3: 899±733, CD8: 404±433 cells/mm2; urothelial carcinomas CD3: 1167±1206, p=0.31; CD8: 582±864 cells/mm2, p=0.27). Positive PD-L1 staining was found in 39% of urothelial cancers, but in only 8% of small-cell bladder cancer cases (p=0.04). Concordant with these data, a sharp decrease of PD-L1 positivity from >80% to 0% positive cells and of TILS in the CT from 466-1063 CD3-positive cells/mm2 to 50-109 CD3-positive cells/mm2 was observed in two cancers with clear-cut progression from “classical” urothelial to small-cell carcinoma. In conclusion, these data demonstrate that small-cell bladder cancer commonly exhibits an immune-excluded phenotype.

scholarly journals Not such a small diagnosis: small cell carcinoma of the prostate

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Abdul Rauf ◽  
Stephanie F Smith ◽  
Rono Mukherjee ◽  
Nyla Nasir
Keyword(s):  
Prostate Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Targeted Therapies ◽  
Specific Antigen ◽  
Serum Levels ◽  
Prostate Adenocarcinoma ◽  
Small Cell ◽  
Neck Swelling ◽  
Genomic Typing

Abstract Small cell carcinoma (SCC) is an aggressive malignancy most commonly described in the lung. We present a case of a 61-year-old male who presented with a neck swelling and was subsequently found to have metastatic SCC of the prostate. Clinicians should be aware that it metastasizes early. Unlike conventional prostate adenocarcinoma, it is not a prostate-specific antigen (PSA) secreting tumor hence serum levels do not correlate with disease severity, and a low PSA reading may give false reassurance. In the future, further studies on genomic typing and novel targeted therapies may achieve better clinical outcomes for patients with this aggressive type of prostate cancer.

Primary genitourinary small cell carcinoma: Clinicopathologic and survival outcomes from SEER database.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 200-200
Author(s):  
R. Thota ◽  
S. Birdsong ◽  
S. Subbiah
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Renal Cancer ◽  
Small Cell ◽  
External Beam Radiation ◽  
Seer Database ◽  
Specific Mortality ◽  
Cancer Specific Mortality

200 Background: Small cell carcinoma of genitourinary system (SCC) is a highly aggressive and rare entity. The aim of the study is to characterize the clinicopathologic characteristics and evaluate the treatment outcomes of SCC in adult patients. Methods: Retrospective analysis of 732 patents diagnosed with small cell carcinoma of bladder from 1973 to 2007 was done via SEER database. Demographics, stage, type of treatment received and cancer-specific mortality were examined. Results: 732 patients were identified with SCC of genitourinary tract of which 341 were small cell bladder cancer, 336 were small cell prostate cancer and 55 were small cell renal cancer. Of these 644 patients were males and 88 were females. Median age of diagnosis is 73 years for bladder, 72 years for prostate and 70 years for renal cancer. Majority of the patients were Caucasians (89%) followed by African Americans (6%) and other races (4.98%). Grading of the tumor revealed that 12 patients had well differentiated tumor, 18 patients had moderately differentiated tumor, 191 patients had poorly differentiated, 292 patients had undifferentiated tumor and 219 patients had unknown grade. Pathological T-stages were as follows: T1= 34 (4.6%), T2= 102 (14%), T3= 43 (9%), T4= 41 (5.6%), 38.4% unknown T stage and 67 (9%) patients had metastatic disease. In majority of the patients the treatment received was unknown (565), 90 patients received external beam radiation, and 76 patients received surgery. Cancer-specific mortality was 54% in bladder cancer, 71% in prostate cancer and 78.6% in renal cancer. Median overall survival for all stages was 15.8 months in bladder cancer, 11.3 months in prostate cancer and 8 months in renal cancer. Conclusions: Results show that SCC is a highly aggressive tumor with poor prognosis. Clinical trials involving multiple institutes are needed to accrue enough patients so that treatment paradigms for this uncommon disease can be developed. No significant financial relationships to disclose.

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

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.

scholarly journals Optimal Postoperative Treatment for Composite Laryngeal Small Cell Carcinoma

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Koji Ebisumoto ◽  
Akihiro Sakai ◽  
Kenji Okami ◽  
Ryousuke Sugimoto ◽  
Kosuke Saito ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Treatment Strategies ◽  
Neck Region ◽  
Small Cell ◽  
Postoperative Treatment ◽  
Pathological Examination ◽  
Tumor Biopsy ◽  
Head And Neck Region

Small cell carcinoma (SmCC) most commonly occurs in the lung and rarely arises from the head and neck region. Further, composite SmCC is extremely rare. Therefore, no postoperative treatment strategy has been established. We report a 59-year-old male patient referred to our outpatient clinic for further examination and treatment of a laryngeal tumor. Biopsy from the tumor revealed squamous cell carcinoma (SCC). The preoperative diagnosis was supraglottic SCC (T3N2bM0), and total laryngectomy and bilateral neck dissection were performed. Pathological examination revealed 2 individual cancer components: SmCC and SCC. Postoperative chemoradiotherapy (2 courses of cisplatin (CDDP) and etoposide (VP-16)) was indicated. Following the postoperative chemoradiotherapy, 2 courses of adjuvant chemotherapy were administered. The patient is currently alive with no evidence of disease at 36 months following the completion of therapy. Postoperative chemoradiotherapy and adjuvant chemotherapy are optimal treatment strategies for laryngeal composite SmCC.

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