Scand J Urol Nephrol
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Scand J Urol Nephrol · Dec 1996
Case ReportsProgression from adenocarcinoma to small cell carcinoma of the prostate with normalization of prostate-specific antigen (PSA) levels.
We report a case of prostatic cancer in which transformation from adenocarcinoma into small cell carcinoma was demonstrated both by histology and immunohistochemistry. This phenomenon supports the hypothesis that small cell carcinoma of the prostate originates from multipotential prostatic epithelial cells.
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We describe the clinical and pathological findings in two Japanese men with small cell carcinoma of the prostate; case 1 was 58 years old and case 2 was 24 years old. Case 1 was initially diagnosed as a poorly differentiated adenocarcinoma of the prostate, stage D2, with marked elevation of serum neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), and CA 19-9 levels. The patient had undergone castration and systemic chemotherapy. ⋯ CEA was intensely positive in the tumour lesions from case 1, and NSE and ACTH were focally positive, and calcitonin, serotonin, CA 19-9, and PSA were weakly positive only in several cells in the tumour lesions from case 1. In the tumour lesion from case 2, NSE was intensely positive, and chromogranin A was weakly positive. These findings support the neuroendocrine nature of this neoplasm.