Pure small-cell carcinoma (SCC) of the prostate is a rare entity and one of the most aggressive malignancies of the prostate.
Histologically, prostatic SCCs of the prostate are part of a spectrum of anaplastic tumours of the prostate and are similar to SCCs of the lungs. In most cases, SCC of the prostate is associated with conventional prostatic adenocarcinoma. Both components of these mixed tumours frequently share molecular alterations such as ERG gene rearrangements or AURKA and MYCN amplifications, suggesting a common clonal origin. The clinical behaviour of small-cell prostate carcinomas is characterized by extensive local disease, visceral disease, and low PSA levels despite large metastatic burden. Commonly, the emergence of the SCC occurs in patients with high-grade adenocarcinoma who are often treated with androgen deprivation treatment (ADT). However, SCCs do not usually benefit from ADT. A biopsy of accessible lesions is strongly recommended to identify those with SCC pathological features, as management is undoubtedly affected by this finding. Chemotherapy is the standard approach for treating patients with either localized or advanced prostatic SCC. Despite the emergence of more-aggressive treatment modalities, the prognosis of men with prostatic SCC remains dismal.
Written by:
Nadal R, Schweizer M, Kryvenko ON, Epstein JI, Eisenberger MA. Are you the author?
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, 1650 Orleans Street, Baltimore, MD 21231-1000, USA; Department of Pathology, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4100, Miami, FL 33136, USA; Department of Pathology, Johns Hopkins Hospital, The Weinberg Building, Room 2242, 401 North Broadway Street, Baltimore, MA 21231, USA.
Reference: Nat Rev Urol. 2014 Feb 18. Epub ahead of print.
doi: 10.1038/nrurol.2014.21
PubMed Abstract
PMID: 24535589
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