Prostate cancer with small-cell morphology: An immunophenotypic subdivision

Petraki, Constantina; Vaslamatzis, Michael; Petraki, Kalliopi; Revelos, Kyriakos; Alevizopoulos, Nektarios; Papanastasiou, Panagiotis; Gregorakis, Alkiviadis

doi:10.1080/00365590500199855

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…These results are consistent with those published by Petraki et al , in which 86% of biopsies of SCC stained positively for synaptophysin and 71% for chromogranin A. [16] Other neuropeptides that may be synthesized by neuroendocrine cells and stain positive immunohistochemically include somatostain, alpha-human chorionic gonadotropin, and parathyroid hormone-related protein. [17] In differentiating small-cell prostate carcinoma from adenocarcinoma, TTF-1 and CD56 are also helpful markers.…”

Section: Discussionsupporting

confidence: 92%

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

Brownback¹,

Renzulli²,

DeLellis³

et al. 2009

Indian J Urol

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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).

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Section: Discussionsupporting

confidence: 92%

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

Brownback¹,

Renzulli²,

DeLellis³

et al. 2009

Indian J Urol

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“…However, Papandreou et al . suggested that surgery could not be the proper treatment modality of SCCP due to the fact that most cases with SCCP have a distant metastasis at initial diagnosis [13]. Radiation therapy might be considered for local control of the disease with chemotherapy [14].…”

Section: Discussionmentioning

confidence: 99%

Small cell carcinoma of the prostate presenting with skin metastasis: a case report

et al. 2014

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IntroductionSmall cell carcinoma of the prostate is a very rare and aggressive type of prostatic cancer. Most cases are diagnosed at advanced stage due to early metastasis. The bones, liver, regional and distant lymph nodes are the most common sites of metastasis of small cell carcinoma of the prostate. Skin metastasis of small cell carcinoma of the prostate is a very rare entity due to the uncommon metastatic site. Here, we describe the case of a patient with small cell carcinoma of the prostate which metastasized to his skin.Case presentationA 74-year-old Caucasian man presented to another urology center for mild lower urinary tract symptoms in 2003. His prostate-specific antigen was 23ng/mL. According to the physical examination signs and prostate-specific antigen, he underwent a transrectal ultrasound-guided prostate biopsy. The pathologic examination of his prostate revealed a Gleason score: 3+4=7 adenocarcinoma of the prostate. Investigations showed stage T2N0M0 disease and he was treated with radiotherapy to his pelvic lymph nodes and prostate. Six years after the initial diagnosis, he complained of a palpable left-side 2×2cm subcutaneous solitary mass localized just behind his scapula. The results of his laboratory tests including serum acid phosphatase and prostate-specific antigen were in normal ranges. Our general surgery department performed a diagnostic biopsy of the mass and totally excised the lesion. The pathologic examination of the mass showed small cell carcinoma metastasis with chromogranin + and the pathologist advised us to examine the lung or prostate for the primary tumor. The patient undertook a transrectal ultrasound-guided prostate biopsy and the pathologic result revealed small cell carcinoma within residual adenocarcinoma. We investigated the other sites for metastasis and restaging investigations showed a 1cm metastatic lesion in his liver. Our medical oncology department decided to treat him with combination chemotherapy with etoposide and cisplatin in six cycles; however, he died due to disseminated myocardial infarction before starting the fifth combination chemotherapy cycle.ConclusionsClinicians should keep in mind that early diagnosis of this disease is very difficult due to early metastatic spread of small cell carcinoma and lack of concordant elevation of prostate-specific antigen. There is no accepted standard treatment modality for this pathology and overall prognosis is poor.

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“…Potentially modulated by a long list of factors, it can be considered as a universal regulator of NE phenotype. However, the proliferative activity of NE tumor cells of SCPC generally contrasts with that observed in adeno-PC even when assessment is performed at advanced stage (106). Although the proliferation rate of adeno-PC certainly increases in the metastatic setting, adeno-PC is still considered as a slow progressing tumor type (42), and it seems likely that tumor cells confined into NE-like clusters are likewise slow-growing or quiescent (Figure 1).…”

Section: Integrating Neuroendocrine Differentiation In the Context Ofmentioning

confidence: 99%

The Many Faces of Neuroendocrine Differentiation in Prostate Cancer Progression

2014

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In normal prostate, neuroendocrine (NE) cells are rare and interspersed among the epithelium. These cells are believed to provide trophic signals to epithelial cell populations through the secretion of an abundance of neuropeptides that can diffuse to influence surrounding cells. In the setting of prostate cancer (PC), NE cells can also stimulate surrounding prostate adenocarcinoma cell growth, but in some cases adenocarcinoma cells themselves acquire NE characteristics. This epithelial plasticity is associated with decreased androgen receptor (AR) signaling and the accumulation of neuronal and stem cell characteristics. Transformation to an NE phenotype is one proposed mechanism of resistance to contemporary AR-targeted treatments, is associated with poor prognosis, and thought to represent up to 25% of lethal PCs. Importantly, the advent of high-throughput technologies has started to provide clues for understanding the complex molecular profiles of tumors exhibiting NE differentiation. Here, we discuss these recent advances, the multifaceted manner by which an NE-like state may arise during the different stages of disease progression, and the potential benefit of this knowledge for the management of patients with advanced PC.

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Prostate cancer with small-cell morphology: An immunophenotypic subdivision

Abstract: U-PC-SCM with a neuroendocrine immunophenotype is a histogenetically distinct entity with different clinical and laboratory manifestations which responds well to a cisplatin + etoposide CTH regimen.

Cited by 14 publications

References 34 publications

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

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

Small cell carcinoma of the prostate presenting with skin metastasis: a case report

The Many Faces of Neuroendocrine Differentiation in Prostate Cancer Progression

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