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Small-cell prostate carcinoma: A retrospective analysis of five newly reported cases.

Brownback KR, Renzulli J, Delellis R, Myers JR - Indian J Urol (2009)

Bottom Line: The PSA levels varied greatly, with two patients possessing markedly elevated levels and the remaining patients with normal levels.Approximately 3/5 patients developed liver metastases, 2/5 patients had bone metastases, and 1/5 patients developed carcinomatous meningitis.Of the four patients who expired, the median survival time after diagnosis of SCC was 3.6 months (0.5-12 months).

View Article: PubMed Central - PubMed

Affiliation: Departments of Urology, Pathology, and Medicine, Brown University, Warren Alpert School of Medicine, USA.

ABSTRACT
Five cases of small-cell carcinoma (SCC) of prostate were identified, at the Rhode Island Hospital and the Miriam Hospital from 1984 to 2006, with an average age of 71 years at the time of diagnosis. Three of these patients had a prior diagnosis of prostatic adenocarcinoma, with all of the five patients receiving anti-androgen treatment. The average time between the diagnosis of adenocarcinoma and of SCC in these patients was 6.7 years. The PSA levels varied greatly, with two patients possessing markedly elevated levels and the remaining patients with normal levels. Approximately 3/5 patients developed liver metastases, 2/5 patients had bone metastases, and 1/5 patients developed carcinomatous meningitis. Of the four patients who expired, the median survival time after diagnosis of SCC was 3.6 months (0.5-12 months).

No MeSH data available.


Related in: MedlinePlus

A 40× magnification H&E stain of case 4 at this presentation shows transition of the adenocarcinoma to a small cell neuroendocrine carcinoma.
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Figure 0002: A 40× magnification H&E stain of case 4 at this presentation shows transition of the adenocarcinoma to a small cell neuroendocrine carcinoma.

Mentions: On the second day in hospital the patient underwent cystoscopy to evaluate the etiology of the obstructive renal failure and for prostate biopsy, which revealed poorly differentiated carcinoma. On day three, a liver ultrasound revealed marked heterogeneity concerning for metastatic disease. A left-sided percutaneous nephrostomy was performed on day four to relieve the obstructive hydronephrosis. On day nine, an abdominal MRI demonstrated diffuse metastatic disease of the liver and therefore a liver biopsy was performed. On hospital day 11, the carcinoembryonic antigen (CEA) was found to be 4155 U/ml, but PSA was undetectable. A noncontrast CT of the chest, abdomen, and pelvis revealed multiple bilateral pulmonary nodules consistent with diffuse metastases as well as enlarged lymph nodes in the chest and retroperitoneum. The liver biopsy demonstrated metastatic high-grade neuroendocrine carcinoma with mixed small and large cell features; the same histology was seen on subsequent review of the prostate biopsy [Figure 2]. He continued to become more encephalopathic and edematous, and was deemed not to be a candidate for chemotherapy given his extensive metastatic disease. He expired on hospital day 17 from presumed sepsis.


Small-cell prostate carcinoma: A retrospective analysis of five newly reported cases.

Brownback KR, Renzulli J, Delellis R, Myers JR - Indian J Urol (2009)

A 40× magnification H&E stain of case 4 at this presentation shows transition of the adenocarcinoma to a small cell neuroendocrine carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2710081&req=5

Figure 0002: A 40× magnification H&E stain of case 4 at this presentation shows transition of the adenocarcinoma to a small cell neuroendocrine carcinoma.
Mentions: On the second day in hospital the patient underwent cystoscopy to evaluate the etiology of the obstructive renal failure and for prostate biopsy, which revealed poorly differentiated carcinoma. On day three, a liver ultrasound revealed marked heterogeneity concerning for metastatic disease. A left-sided percutaneous nephrostomy was performed on day four to relieve the obstructive hydronephrosis. On day nine, an abdominal MRI demonstrated diffuse metastatic disease of the liver and therefore a liver biopsy was performed. On hospital day 11, the carcinoembryonic antigen (CEA) was found to be 4155 U/ml, but PSA was undetectable. A noncontrast CT of the chest, abdomen, and pelvis revealed multiple bilateral pulmonary nodules consistent with diffuse metastases as well as enlarged lymph nodes in the chest and retroperitoneum. The liver biopsy demonstrated metastatic high-grade neuroendocrine carcinoma with mixed small and large cell features; the same histology was seen on subsequent review of the prostate biopsy [Figure 2]. He continued to become more encephalopathic and edematous, and was deemed not to be a candidate for chemotherapy given his extensive metastatic disease. He expired on hospital day 17 from presumed sepsis.

Bottom Line: The PSA levels varied greatly, with two patients possessing markedly elevated levels and the remaining patients with normal levels.Approximately 3/5 patients developed liver metastases, 2/5 patients had bone metastases, and 1/5 patients developed carcinomatous meningitis.Of the four patients who expired, the median survival time after diagnosis of SCC was 3.6 months (0.5-12 months).

View Article: PubMed Central - PubMed

Affiliation: Departments of Urology, Pathology, and Medicine, Brown University, Warren Alpert School of Medicine, USA.

ABSTRACT
Five cases of small-cell carcinoma (SCC) of prostate were identified, at the Rhode Island Hospital and the Miriam Hospital from 1984 to 2006, with an average age of 71 years at the time of diagnosis. Three of these patients had a prior diagnosis of prostatic adenocarcinoma, with all of the five patients receiving anti-androgen treatment. The average time between the diagnosis of adenocarcinoma and of SCC in these patients was 6.7 years. The PSA levels varied greatly, with two patients possessing markedly elevated levels and the remaining patients with normal levels. Approximately 3/5 patients developed liver metastases, 2/5 patients had bone metastases, and 1/5 patients developed carcinomatous meningitis. Of the four patients who expired, the median survival time after diagnosis of SCC was 3.6 months (0.5-12 months).

No MeSH data available.


Related in: MedlinePlus