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

Whitaker, D.; Miller, Daniel; Jagadesh, Niveditha; Strong, Gerald; Hintenlang, L.; Schenk, William B.; Broderick, Gregory A.; Tzou, Katherine S.; Buskirk, Steven J.

doi:10.4081/rt.2016.6657

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…The rarity of primary NEPC means that most available studies to date have been case reports. [7][8][9][10][11] Zaffuto et al 12 Although the difference between the median survival times was statistically significant, this did not translate into a notable clinical difference. Most T-SCNCs present initially as prostate adenocarcinomas, which then undergo neuroendocrine (NE) differentiation.…”

Section: Introductionmentioning

confidence: 99%

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Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Wang

Abudurexiti

et al. 2019

The Prostate

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Background The rarities of primary neuroendocrine prostate cancer (NEPC) and primary adenocarcinoma with neuroendocrine differentiation (NE differentiation) mean that their clinical characteristics have not been fully elucidated. Materials and Methods A total of 449 patients with NEPC, including 352 cases of pure NEPC and 97 cases of NE differentiation, together with 408 629 cases of prostate adenocarcinoma at diagnosis were retrieved from the Surveillance, Epidemiology, and End Results program (2010‐2015). Clinical parameters and prognoses were compared between patients with different histological types of NEPC using the χ2 test and Kaplan‐Meier analysis, respectively. The prognostic value of prostate‐specific antigen (PSA) in NEPC and adenocarcinoma was evaluated using Cox regression and the Kaplan‐Meier method. Results Pure NEPC had higher rates of visceral metastases (brain, lung, and liver: 4.58%, 26.72%, and 36.64%, respectively) but a lower rate of bone metastasis (65.65%) compared with NE differentiation and prostate adenocarcinoma. Moreover, patients diagnosed with pure NEPC had a poorer outcome (median survival time: 10 months) compared with patients with NE differentiation (26 months) and prostate adenocarcinoma (median survival time not reached). Using PSA 4.1 to 10 ng/mL as the reference, the adjusted hazard ratios (HRs) for PSA lower than or equal to 4.0 ng/mL were 2.24 (95% confidence interval [CI]: 1.11‐4.55, P = .025) in the NE differentiation group and 1.57 (95% CI: 1.11‐2.23, P = .011) in the pure NEPC group. Conclusions Patients with NE differentiation had different clinical characteristics and a better prognosis than patients with pure NEPC. In addition, low‐serum PSA levels were associated with a poorer prognosis in patients with either NEPC or NE differentiation.

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Section: Introductionmentioning

confidence: 99%

“…The rarity of primary NEPC means that most available studies to date have been case reports . Zaffuto et al and Alanee et al explored the differences in prognostic and clinical data between patients with the small‐cell carcinoma (SCC) subtype of NEPC and those with non‐SCC NEPC.…”

Section: Introductionmentioning

confidence: 99%

Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Wang

Abudurexiti

et al. 2019

The Prostate

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“…Although the prostate is one of the common site for EPSCC, it is a rare prostatic malignancy. 2 , 3 , 9 Of these cases, only about 35% are pure SCC of the prostate, with the rest having concurrent adenocarcinomatous components, 5 but it is currently unknown whether this pathological difference affects the management or prognosis. SCC of the prostate is reported to be more prevalent in the elderly with over 70% of patients being over the age of 65.…”

Section: Discussionmentioning

confidence: 99%

“…However, albeit rare, extrapulmonary SCC (EPSCC) can occur in a variety of sites with an incidence in North America approximated to be 0.1% to 0.4%. 1 Among these sites, approximately 10% of EPSCC cases occur in the prostate 2 , 3 and are associated with a poor survival, with a median survival of 10 months. 3 , 4 Because of the rarity of the prostatic SCC, there is no formal treatment protocol.…”

Section: Introductionmentioning

confidence: 99%

Small Cell Carcinoma of Prostate: A Case Report of a Patient With Concomitant Transitional Cell Cancer of the Bladder

Abusnina

Auyoung

Megri

et al. 2018

Journal of Investigative Medicine High Impact Case Reports

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Small cell carcinomas (SCCs) are aggressive neoplasms commonly associated with a pulmonary origin. However, albeit rare, extrapulmonary SCC can occur in a variety of sites with an incidence in North America approximated to be 0.1% to 0.4%. Among these sites, approximately 10% of extrapulmonary SCC cases occur in the prostate and are associated with a poor mortality with a median survival of 10 months. Because of the rarity of the prostatic SCC, there is no formal treatment protocol. In this case report, we present a patient who was diagnosed with SCC in the prostate as primary origin. Adjuvant concurrent chemoradiotherapy was started, which he is tolerating so far. While the management of metastatic disease is well documented with the use of chemotherapy, specific data on nonmetastatic disease is lacking. As some studies suggest, a combined surgical and chemotherapeutic approach is helpful in localized disease. In our case, this approach has led to a good clinical outcome in a disease that does not usually allow such results.

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“…SCC (EPSCC) can occur in a variety of sites with the incidence in North America approximated at 0.1% to 0.4% [6]. Among the possible sites for EPSCC, approximately 10% of cases arise in the prostate [7,8] and are associated with a poor median survival of 10 months [9].…”

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confidence: 99%

Molecular analysis and literature-based hypothesis of an immunonegative prostate small cell carcinoma causing ectopic ACTH syndrome

et al. 2019

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Ectopic ACTH syndrome (EAS) due to a prostate small cell carcinoma (SCC) is very rare with only 26 cases reported to date and has a poor prognosis. We here describe another case of this disorder that was clinically typical based on prior reports as it showed hypercortisolemia and severe hypokalemia with multiple metastasis. However, our current case of prostate SCC causing EAS is the first to display negative immunostaining for ACTH despite detectable POMC mRNA expression in the primary lesion. ACTH immunonegativity is thought to be associated with a more aggressive disease course and a poorer prognosis although there are few studies of the underlying mechanisms. We explored two possibilities for this finding in our current patient: aberrant POMC processing prevented immunodetection with an anti-ACTH antibody; and the ACTH content per cell was below the threshold for immunodetection due to its rapid secretion or low synthesis. The aberrant processing theory was thought to be less likely because of immunonegative findings even using anti-POMC/ACTH antibodies. As the plasma ACTH levels in our patient were comparable with those reported for previous immunopositive prostate EAS cases, we speculated that the depletion of ACTH may be caused not only by rapid secretion but also by low production levels as a sign of de-differentiation. De-differentiation may therefore explain the mechanism underlying the negative correlation between immunoreactivity for ACTH in EAS and disease aggressiveness. We believe that our present findings will be of use in future prospective studies aimed at confirming the mechanism of immunonegativity.

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

Cited by 8 publications

References 13 publications

Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Small Cell Carcinoma of Prostate: A Case Report of a Patient With Concomitant Transitional Cell Cancer of the Bladder

Molecular analysis and literature-based hypothesis of an immunonegative prostate small cell carcinoma causing ectopic ACTH syndrome

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