Transitional Cell Carcinoma of the Prostate: Response to Treatment with Adriamycin and Cis-Platinum

Abstract

A patient with metastatic transitional cell carcinoma of the prostate achieved an impressive clinical response to treatment with Adriamycin and cis-platinum. The treatment of transitional cell carcinoma of the prostate is discussed and the literature is reviewed.Cancer 51:1800-1802. 1983. RANSITIONAL CELL CARCINOMA of the prostate T (TCC) comprises 2 to 3% of most large series of prostate cancer cases.'-3 This unusual tumor originates from the transitional cell layer of the periurethral prostatic ducts and may differ significantly in clinical characteristics in comparison to the more common adenocarcinoma arising from peripheral prostatic acinar glands.' Response to standard therapy is poor and survival in patients with metastatic TCC is limited.2.3.5.6 The present report describes our experience in the treatment of TCC in a patient with widespread metastatic disease who achieved an impressive clinical response following treatment with combination chemotherapy to include Adriamycin and cis-platinum. Case ReportA 65-year-old white man noted low back pain and hesitancy on urination seven months prior to evaluation. Rectal examination of the prostate revealed an enlarged gland. Serum acid phosphatase was normal. X-ray of lumbar spine demonstrated a lytic lesion at L-4 and subsequent cystoscopy and prostate biopsy revealed only inflammatory change. Transurethral resection demonstrated transitional cell carcinoma of the prostate (Figs. 1A and IB). Metastatic work-up included bone scan with numerous areas of increased uptake in spine, ribs and pelvis, and liver-spleen scan with hepatomegaly and multiple filling defects. The patient's clinical status deteriorated rapidly. He developed large, bilateral pleural and peri-* Hematology-Oncology Service, Walter Reed Army Medical Center, Washington, DC.