Small cell carcinoma of the prostate: a case report

A 81-year-old man was admitted to our department with the chief complaints of pollakisuria and difficulty in voiding. He presented with increased serum PSA level (over 100 ng/ml). We performed biopsy of the prostate and found a moderately differentiated adenocarcinoma. Various urological examinations showed metastases to paraaortic lymph nodes and systemic bones. He was started-on hormonal therapy. Nine months from the start of hormonal therapy, this therapy was effective and the serum PSA level was decreased to 14 ng/ml. Thereafter, the serum PSA level and the tumor volume were increased and he died 29 months from the start of treatment. The autopsy revealed small cell carcinoma with adenocarcinoma of the prostate.     

Small cell carcinoma of the prostate: a case report

A 76-year-old man had been treated with maximum androgen blockade therapy for a poorly-differentiated prostate adenocarcinoma (T3cN1M0, prostate specific antigen (PSA) 65 ng/ml, Gleason Score 4+5=9) since September 2002. By August 2003, his serum PSA levels were undetectable and the lymph node swelling had vanished. However, in December 2004, his serum PSA levels started rising gradually up to 0.66 ng/ml. Radiation therapy on the prostate was then performed (66 Gy). At that time, no metastasis was detected by computed tomography and bone scintigraphy. In August 2005, multiple bone metastases were detected. Immunohistochemical examination of a biopsy specimen from the bone lesion revealed a small cell carcinoma/neuroendocrine cell carcinoma. He died with undetectable PSA levels (less than 0.008 ng/ml) in December 2005. The autopsy showed multiple organ metastases including bone, liver, lungs and others. The immunohistochemical examination revealed pure small cell carcinoma in all metastatic lesions. A precise histological examination of the lungs using a 1 cm serial section could not reveal any tumors compatible with primary lung cancer. We concluded from the clinical history and autopsy findings that his initial poorly-differentiated adenocarcinoma of the prostate dedifferentiated into a pure small cell carcinoma with neuroendocrine differentiation.     

Small cell carcinoma of the prostate: a case report

A 79-year-old man was admitted to our department with a chief complaint of urinary incontinence. The prostate was enlarged (145 cc), although the serum level of prostate specific antigen (PSA) was within the normal range (1.09 ng/ml). Digital rectal examination showed an enlarged, irregular prostate with stony hardness. We performed a prostate biopsy and histological examinations indicated poorly differentiated adenocarcinoma with a Gleason score of 5+5=10. A computed tomographic (CT) scan revealed a prostatic tumor invading the bladder, seminal vesicle and rectum. He was diagnosed with a stage T4N1M0 adenocarcinoma of the prostate. He was started-on hormonal therapy, but died one month from the start of treatment. Histological and immunohistological examinations were repeated; suggesting small cell neuroendocrine carcinoma of the prostate.     

Small cell carcinoma of the prostate: a case report

An 80-year-old man visited our hospital because of dysuria and pollakisuria. He had undergone anti-androgen therapy for prostate cancer for 8 months at another hospital. His serum prostate specific antigen (PSA) level was 14.4 ng/ml. We performed a prostate biopsy and identified poorly differentiated adenocarcinoma with Gleason score 4 + 5. After 4 months, his serum PSA level increased to 24.8 ng/ml, and we started maximum androgen blockade therapy using additional luteinizing hormone-releasing hormone (LH-RH) analogue. Subsequently, although his serum PSA level declined favorably, his condition worsened rapidly and he died at 16 months after the diagnosis. The autopsy pathology of his prostate revealed small cell carcinoma. We reviewed the initial biopsy specimens and found both small cell carcinoma and adenocarcinoma histologic types of prostate cancer.     

Small cell carcinoma of the prostate: a case report

Pure small cells carcinoma of the prostate is a rare tumour with a pejorative forecast. We report a case of neuroendocrine small cells carcinoma developed at a 68 years old patient. This tumour expressed a positive marking immunohistochimic with chromogranin A, the rate of PSA was on the other hand normal (2.9 ng/ml). The patient was treated by chemotherapy associating etoposide and cisplatinium and external radiotherapy. He is deceased 4 months afterwards.     

Small cell carcinoma of the prostate: an immunohistochemical study

Small cell carcinoma of the prostate (SCPC) is morphologically similar to small cell carcinoma of the lung (SCLC) and maybe misinterpreted as Gleason pattern 5b prostate adenocarcinoma (HGPC). Recognition of SCPC is important because of its different clinical behavior. This study aims to characterize the immunophenotype of histologically classic SCPC using a comprehensive panel of markers, to better understand its histogenesis, aid in its classification, and evaluate potential therapeutic targets. Using the World Health Organization morphologic criteria for SCLC, 18 SCPC cases were identified; and studied for the following tumor marker groups: prostate specific/related, neuroendocrine, sex steroid hormone receptors, and prognostic/treatment target-related. Ten cases of UPC were used as controls. PSA was positive in 17% of SCPC and neuroendocrine markers were expressed in HGPC. PSA, TTF-1 and CD56 were the most helpful markers in differentiating between SCPC and HGPC (P<0.01), whereas bombesin/GRP, c-kit, bcl-2, and EGFR expression was more frequent in SCPC. SCPC is best diagnosed by following the World Health Organization diagnostic criteria for SCLC. Immunohistochemical markers can help separate SCPC from HGPC and may be useful in histologically borderline cases. Potential therapeutic targets are identified immunohistochemically in SCPC (Bombesin/GRP, c-kit, bcl-2, and EGFR).     

Basal cell carcinoma of the prostate: a case report

A 69-year-old man presented with gross hematuria and irritative urinary symptoms. He underwent transurethral resection of his prostate. The prostate chips revealed 70% poorly differentiated carcinoma with neuroendocrine features, initially read as small cell carcinoma, later as basal cell carcinoma. PSA at this time was 0.3. He received 4 cycles of etoposide and cisplatin. After which, rebiopsy of the prostate showed tumor consistent with poorly differentiated basal cell carcinoma. Given progression on chemotherapy, decision was made to proceed with radical prostatectomy. Metastatic workup was negative. Gross extraprostatic invasion was noted but lymph nodes were free of metastatic disease.     

Small cell carcinoma of the kidney: a case report

A 79-year-old man presented in August 2002 with right flank pain, anorexia, and gross hematuria. Physical examination was significant for a palpable, nontender, firm, and fixed mass in the epigastric region. Computed tomography scan of abdomen revealed a 15 cm tumor occupying almost the whole right kidney with extension into the inferior vena cava. The para-aortic and retroperitoneal lymph nodes were significantly enlarged. Examinations including bone scintigram and chest X-ray revealed no metastases. The patient underwent a ultrasound sonography-guided biopsy of the renal tumor, which showed a small cell carcinoma pathologically, and immunohistochemically. The patient received palliative treatment, and died in February 2003. We reviewed 25 cases including our case, and analyzed the clinical outcome of small cell carcinoma of the kidney.     

Small cell carcinoma of the bladder: a case report

A 61-year-old man was referred to our hospital with a complaint of gross hematuria and lower abdominal discomfort. Ultrasonography, magnetic resonance imaging and cystoscopy revealed a nodular invasive tumor in urinary bladder. The histopathological findings of transurethral-biopsy specimen was the small cell carcinoma and transitional cell carcinoma of the bladder infiltrating into smooth muscle layer. Total cystectomy with ileal conduit was performed following 1 course of neoadjuvant chemotherapy (M-VAC). Computed tomography (CT) before adjuvant chemotherapy revealed tiny lung metastasis in left peripheral lung area. As postoperative adjuvant therapy, 4 courses of chemotherapy (etoposide and calboplatin) were performed with 50 Gy of extra beam radiotherapy to the lung metastasis. Follow up CT revealed disapperance of lung metastasis, and the patient has been free from disease for one year after chemotherapy.     

Small cell carcinoma of the prostate successfully treated with combined chemotherapy and radiotherapy: a case report

A 49-year-old man complained of dysuria and pollakisuria. The prostate was enlarged, and the serum level of prostate specific antigen was within the normal range. Under the diagnosis of benign prostatic hypertrophy, transurethral resection of the prostate was performed. Unexpectedly, histopathological examination of the resected tissues revealed pure small cell carcinoma. The serum level of progastrin-releasing peptide (ProGRP) was slightly elevated. The cancer was clinically diagnosed as stage C. Pelvic radiotherapy combined with chemotherapy using cisplatin (CDDP) and etoposide (VP-16) was started according to the treatment for limited small cell cancer of the lung. After one month, the serum level of ProGRP decreased to the normal range. After four months, the prostate was reduced in size without any findings of metastases on computed tomography, and prostate biopsy revealed no viable cancer cells.     

Primary squamous cell carcinoma of the prostate: a case report

The patient was a 72-year-old man who visited our hospital with a chief complaint of pollakisuria. Digital rectal examination suggested prostatic carcinoma, but prostate specific antigen level was within normal limits. Transperineal needle biopsy was performed and histology was squamous cell carcinoma. Because of the urinary retention, transurethral resection of the prostate was performed and histological examination revealed squamous cell carcinoma. In spite of radiotherapy and chemotherapy with cis-platinum, the progression of cancer continued. The patient died about 13 months after the diagnosis.     

Primary transitional cell carcinoma of prostate: a case report

A 67-year-old male was admitted with a three-month history of voiding difficulty. Prostate specific antigen remained within the normal limit. Under the diagnosis of benign prostatic hypertrophy, transurethral resection of prostate was performed. Pathological examination of the resected specimens of the prostate revealed transitional cell carcinoma. Two courses of systemic M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) chemotherapy were performed, followed by cystoprostatourethrectomy, pelvic lymphadenectomy, and ileal conduit construction. Now one year has elapsed, with no clinical signs of recurrence.     

Small cell carcinoma of the cystic duct: A case report

Small cell carcinoma usually involves the lung and rarely affects the biliary tract, especially the cystic duct. In this article we report a case of small cell carcinoma of the cystic duct in a 46-year-old Japanese man. The patient presented with abdominal pain and jaundice. Imaging showed a small nodule in the cystic duct invading the common bile duct with dilatation of the proximal biliary tree. The hepatic artery and portal vein were free from invasion. Extended right hepatic lobectomy, cholecystectomy, and resection of the extrahepatic proximal bile ducts were performed together with lymph node dissection under the tentative diagnosis of carcinoma of the cystic duct. Histopathologic examination of the resected specimen revealed small cell carcinoma arising in the cystic duct and extending into the common bile duct. The postoperative clinical course was uneventful, and the patient is doing well without any signs of recurrence 1 year after the operation. To our knowledge this is the first documented case of a small cell carcinoma arising in the cystic duct.     

Small cell carcinoma of the urinary bladder: a case report

We report a case of small cell carcinoma of the urinary bladder. The patient was a 58-year-old man complaining of gross hematuria. Clinical examination revealed a non-papillary, broad-based tumor on the right bladder wall with a clinical stage of T3a, N0, M0. Neoadjuvant intraarterial infusion chemotherapy with methotrexate, adriamycin and cisplatin was performed, but it was ineffective. Three weeks later we performed a radical cystectomy. The operative specimen of the tumor revealed small cell carcinoma. It was staged pT3aN0M0R0L2V1. Postoperatively, 1 course of adjuvant chemotherapy using cisplatin and etoposide was performed. The patient is alive without any evidence of tumor recurrence at 6 months after operation.     

Small cell carcinoma of the urinary bladder: a case report

We report a case of primary small cell carcinoma of the urinary bladder. A 74-year-old woman was referred to our hospital because of pollakiuria. Cystoscopy showed a papillary tumor. We operated transurethral resection of the bladder tumor (TUR-Bt). Histopathological finding was transitional cell carcinoma (TCC), grade3, pT1 containing pTis. About six months later, tumor recurred to the bladder. Pathologic diagnosis was TCC in part and most was small cell carcinoma. Pelvic magnetic resonance imaging revealed a huge mass lesion with extravesical extension in the urinary bladder, and computed tomography scan showed external iliac lympho node metastasis. The rapid rise of a tumor maker NSE and pro-GRP were remarkable. It was diagnosed as a rapid advance of small cell carcinoma. We performed pelvic radiotherapy, and chemotherapy using carboplatin (CBDCA) and etoposide (VP-16). However 14 months after it had left hospital, computed tomography showed paraaortic lympho node metastasis. The patient died due to rapidly progressive disease.     

Small cell carcinoma of the prostate

Pure small cell carcinoma of the prostate is rare (less than 1% of all prostatic neoplasm). As a result there are few reports in the literature that describe the salient features and appropriate management of this cancer (less than 200 cases reported). Small cell carcinomas of the prostate are a heterogeneous group of tumors, a number of them have neuroendocrine differentiation and are highly aggressive, commonly with visceral metastases at time of diagnosis. Complete temporary remission has been reported with chemotherapy but this tumor has a poor prognosis. The median overall survival from the time of diagnosis is between 5-17.5 months. We report 2 new cases of small cell carcinoma of the prostate and a review of the literature.     

前列腺小细胞癌

前列腺小细胞癌临床罕见,在所有前列腺肿瘤中不超过1%,是前列腺癌高恶性度的组织病理学类型。国内外文献报道很少。确诊主要依赖免疫组织化学。治疗提倡化疗加放疗与激素及手术的联合治疗,预后极为不佳,本文将对这一罕见疾病作一综述。     

Small cell carcinoma of prostate

Small cell anaplastic carcinoma (SCC) involving the prostate is extremely unusual, either as a primary or as a secondary metastatic focus. A case of SCC presenting as prostatic obstruction and diagnosed with prostate biopsy is presented and the literature reviewed.