Transformation of prostatic adenocarcinoma to well-differentiated neuroendocrine tumor after hormonal treatment.
Carcinoid tumor of the prostate is extremely rare. Here we report a unique case of prostate cancer that underwent complete transformation from conventional adenocarcinoma to carcinoid-like tumor shortly after androgen-deprivation treatment (ADT). The patient was a 59-year-old man who presented with lower urinary tract symptoms. His biopsy specimen demonstrated a high-grade prostatic adenocarcinoma with mixed acinar and ductal features. After ADT for 6months, the patient underwent radical prostatectomy. The post-ADT tumor showed monotonous neoplastic cells with fine granular chromatin forming rosette-like structures, resembling a carcinoid tumor. No residual conventional adenocarcinoma was present. On immunostain, the tumor cells were diffusely positive for synaptophysin and chromogranin and negative for prostate-specific antigen and prostein. Thus, the carcinoid-like tumor represented complete transformation from prostatic adenocarcinoma to well-differentiated neuroendocrine tumor after ADT. This unique case highlights the important role of ADT in neuroendocrine differentiation of prostate cancer.
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009.
Syed
S
Gilani
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009. Electronic address: ccguo@mdanderson.org.
Charles C
CC
Guo
Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009.
Elsa M
EM
Li-Ning
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009.
Curtis
C
Pettaway
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009.
Patricia
P
Troncoso
D000230:Adenocarcinoma / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D054338:Cell Transdifferentiation; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009376:Neoplasms, Hormone-Dependent / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor
Adenocarcinoma; Carcinoid; Hormonal treatment; Neuroendocrine differentiation; Prostate cancer