Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen

Introduction. Prostate cancer is one of the most common malignancies in men. The most common type is acinar adenocarcinoma. Small cell prostate cancer (SCPC) usually occurs together with coexisting prostate adenocarcinoma. Case report. A 72-years-old patient with voiding simptoms is presented. Initi...

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Main Authors: Vojinov Saša, Popov Mladen, Levakov Ivan, Levakov-Fejsa Aleksandra, Jeremić Dimitrije, Grbić Dragan
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2020-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900029V.pdf
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author Vojinov Saša
Popov Mladen
Levakov Ivan
Levakov-Fejsa Aleksandra
Jeremić Dimitrije
Grbić Dragan
author_facet Vojinov Saša
Popov Mladen
Levakov Ivan
Levakov-Fejsa Aleksandra
Jeremić Dimitrije
Grbić Dragan
author_sort Vojinov Saša
collection DOAJ
description Introduction. Prostate cancer is one of the most common malignancies in men. The most common type is acinar adenocarcinoma. Small cell prostate cancer (SCPC) usually occurs together with coexisting prostate adenocarcinoma. Case report. A 72-years-old patient with voiding simptoms is presented. Initial level of prostate specific antigen (PSA) was 2.87 ng/mL. Twelve prostate biopsies were taken and in six of them neoplastic tissue was detected. The viewed tissue was most convenient to “small cell carcinoma“. Bone scintigraphy did not demonstrate dissemination of the cancer into the skeletal system. Multislice computed tomography (MSCT) of the pelvis did not reveal any special pathological changes. The patient underwent surgery – radical retropubical prostatectomy. Histopathological analysis revealed a poorly differentiated adenocarcinoma of the prostate with small cell carcinoma zones [Gleason score 5+5 (10), grade III, pT3bN1, stage IV]. Conclusion. Poorly differentiated adenocarcinoma of the prostate, especially in combination with SCPC, is an aggressive malignancy with most cases presenting with the extensive disease dissemination on diagnosis and poor prognosis. Small cell carcinomas of the prostate are extremely rare tumors of the neuroendocrine origin. Patients with mixed prostate cancer, compared to pure SCPC, have a better prognosis and greater survival rate. There is a lack of the evidence guiding treatment for SCPC.
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spelling doaj.art-c030928bf774464088edf5c8fa5db8d72022-12-21T18:19:23ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202020-01-0177101101110310.2298/VSP181212029V0042-84501900029VAdenocarcinoma of the prostate with small cell component and low levels of prostate specific antigenVojinov Saša0Popov Mladen1Levakov Ivan2Levakov-Fejsa Aleksandra3Jeremić Dimitrije4Grbić Dragan5University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Department of Urology, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Department of Urology, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Department of Urology, Novi Sad, SerbiaClinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia + Clinical Center of Vojvodina, Center for Pathology, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Department of Urology, Novi Sad, SerbiaClinical Center of Vojvodina, Department of Urology, Novi Sad, SerbiaIntroduction. Prostate cancer is one of the most common malignancies in men. The most common type is acinar adenocarcinoma. Small cell prostate cancer (SCPC) usually occurs together with coexisting prostate adenocarcinoma. Case report. A 72-years-old patient with voiding simptoms is presented. Initial level of prostate specific antigen (PSA) was 2.87 ng/mL. Twelve prostate biopsies were taken and in six of them neoplastic tissue was detected. The viewed tissue was most convenient to “small cell carcinoma“. Bone scintigraphy did not demonstrate dissemination of the cancer into the skeletal system. Multislice computed tomography (MSCT) of the pelvis did not reveal any special pathological changes. The patient underwent surgery – radical retropubical prostatectomy. Histopathological analysis revealed a poorly differentiated adenocarcinoma of the prostate with small cell carcinoma zones [Gleason score 5+5 (10), grade III, pT3bN1, stage IV]. Conclusion. Poorly differentiated adenocarcinoma of the prostate, especially in combination with SCPC, is an aggressive malignancy with most cases presenting with the extensive disease dissemination on diagnosis and poor prognosis. Small cell carcinomas of the prostate are extremely rare tumors of the neuroendocrine origin. Patients with mixed prostate cancer, compared to pure SCPC, have a better prognosis and greater survival rate. There is a lack of the evidence guiding treatment for SCPC.http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900029V.pdfprostatic neoplasmsprostate-specific antigendiagnostic techniques and proceduresprostatectomydrug therapyprognosis
spellingShingle Vojinov Saša
Popov Mladen
Levakov Ivan
Levakov-Fejsa Aleksandra
Jeremić Dimitrije
Grbić Dragan
Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
Vojnosanitetski Pregled
prostatic neoplasms
prostate-specific antigen
diagnostic techniques and procedures
prostatectomy
drug therapy
prognosis
title Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
title_full Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
title_fullStr Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
title_full_unstemmed Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
title_short Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
title_sort adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen
topic prostatic neoplasms
prostate-specific antigen
diagnostic techniques and procedures
prostatectomy
drug therapy
prognosis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900029V.pdf
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