title: Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center.
abstract: OBJECTIVE
  Neuroendocrine carcinomas (NEC) of the prostate are rare, with only a few series hitherto reported. The objective of this study was to assess in a single institution the clinical and morphologic characteristics of neuroendocrine carcinomas diagnosed in needle core biopsies.
  
  
  METHODS
  The current study analyses seven cases diagnosed in needle biopsies at a large tertiary regional cancer center from Northeastern Brazil. Two pathologists reviewed specimens retrospectively, and demographic and morphologic characteristics were compared to 458 acinar tumors diagnosed in the same period.
  
  
  RESULTS
  There were five small cell carcinomas and two low-grade neuroendocrine carcinomas (carcinoid). NEC were associated with an acinar component in 5/7 cases and the Gleason score of the acinar component was always > 6. The number of cores involved in prostates with NEC was greater (65% compared to 24% of acinar tumors, p < 0.05). The mean PSA at diagnosis was 417.7 (range 5.7-1593, SD 218.3), compared to 100.5 (p = 0.1) of acinar tumors (range 0.3-8545, SD 22.7). Prostates harboring NEC were bigger (p < 0.001, mean volume 240 mL vs. 53 mL of acinar tumors). Treatment of NEC included palliative surgery, chemotherapy, and hormonal therapy.
  
  
  CONCLUSIONS
  NEC of the prostate is rare and often associated with a high-grade acinar component. Prostates with NEC tend to be larger and involve a greater number of cores than acinar tumors. PSA at diagnosis does not seem to predict the presence of NE tumors in needle biopsy.
authors.affiliation: Hospital do Cancer, Instituto do Cancer do Ceara, Fortaleza, Ceara, Brazil. marcosvalima@hotmail.com
authors.forename: M V A
authors.initials: MV
authors.lastname: Lima
authors.forename: C
authors.initials: C
authors.lastname: Nogueira
authors.forename: J A A
authors.initials: JA
authors.lastname: Oliveira
authors.forename: F J
authors.initials: FJ
authors.lastname: Muniz Neto
authors.forename: M
authors.initials: M
authors.lastname: Franco
authors.forename: F
authors.initials: F
authors.lastname: Tavora
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001707:Biopsy, Needle / Q000706:statistics & numerical data; D018278:Carcinoma, Neuroendocrine / Q000473:pathology*; D018288:Carcinoma, Small Cell / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D035583:Rare Diseases / Q000473:pathology*