Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jun 12;12(6):e230116.
doi: 10.1136/bcr-2019-230116.

Carcinosarcoma prostate with osteosarcomatous differentiation: a rare de novo presentation

Sumeet Aggarwal  1 , Swarupa Mitra  1 , Abhinav Dewan  1 , Garima Durga  2
Affiliations
Case Reports

Carcinosarcoma prostate with osteosarcomatous differentiation: a rare de novo presentation

Sumeet Aggarwal et al. BMJ Case Rep. .

Abstract

Carcinosarcoma is a rare histological event in the history of prostatic malignancies. Historically aggressive tumours with dismal outcomes reported in scarce literature available so far. Very few recent studies suggest good outcomes with modern era surgery and radiotherapy techniques in localised disease. The case presented here had no history of known risk factors like prior adenocarcinoma or prior radiation therapy. This case presented with obstructive urinary symptoms with no prostate-specific antigen elevation, diagnosed with imaging, managed aggressively with robotic surgery. Detailed immunohistochemistry and pathological review suggested diagnosis as carcinosarcoma with osteosarcomatous differentiation. Very rare such cases were reported in the past with complete clinical, radiological, pathological details and managed aggressively with good outcomes. The patient is disease free after 6 months of follow-up.

Keywords: prostate; prostate cancer; radiotherapy; urological cancer; urological surgery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Transverse view of pelvis MRI: showing enlarged prostate (5.0×6.3×5.7 cm) with diffusion restriction. Mass lesion (5.0×5.3 cm approximately) was seen involving entire left peripheral zone and central zone with extraprostatic infiltration involving left seminal vesicle and left paraprostatic fat.
Figure 2
Figure 2
Saggital view of pelvis MRI: showing mass lesion of size 5.0×5.3 cm with indentation of urinary bladder base. Posteriorly, the lesion was abutting an anterior wall of the rectum but with maintained fat planes.
Figure 3
Figure 3
18FDG PET: showing FDG avid lesion of size 2.0×2.7×3.5 cm (SUVmax: 14.37) in the peripheral zone of the prostate along the left posterolateral aspect, suggesting the residual mitotic pathology with postsurgery (TURP) inflammatory sequelae. FDG, F-fluorodeoxyglucose; PET, positron emission tomography; TURP, transurethral resection of the prostate.
Figure 4
Figure 4
H&E micrograph: showing sheet of spindle cells with interspersed osteoclastic giant cells, which are infiltrating prostatic tissue along with areas of necrosis and haemorrhage.
Figure 5
Figure 5
IHC: showing SMA focal positivity. IHC, immunohistochemistry; SMA, smooth muscle actin.
Figure 6
Figure 6
SATB2(Special AT-rich binding protein 2) positive in tumour cells, as well as osteoclastic giant cells, are seen.
Figure 7
Figure 7
Tumour cells are negative for cytokeratin  and prostate-specific acid phosphatase.
See this image and copyright information in PMC

References

    1. Bernard T, John RS, Bostwick DG. Soft tissue tumours. Pathology of the Prostate, Bostwick GB, New York: Churchill Livingstone, 1990:117–35.
    1. Dotan ZA, Tal R, Golijanin D, et al. . Adult genitourinary sarcoma: the 25-year Memorial Sloan-Kettering experience. J Urol 2006;176:2033–9. 10.1016/j.juro.2006.07.021 - DOI - PubMed
    1. Ren FY, Lu JP, Wang J, et al. . Adult prostate sarcoma: radiological-clinical correlation. Clin Radiol 2009;64:171–7. 10.1016/j.crad.2008.07.013 - DOI - PubMed
    1. Shannon RL, Ro JY, Grignon DJ, et al. . Sarcomatoid carcinoma of the prostate. A clinicopathologic study of 12 patients. Cancer 1992;69:2676–82. 10.1002/1097-0142(19920601)69:11<2676::AID-CNCR2820691109>3.0.CO;2-P - DOI - PubMed
    1. Sexton WJ, Lance RE, Reyes AO, et al. . Adult prostate sarcoma: the M. D. Anderson Cancer Center Experience. J Urol 2001;166:521–5. 10.1016/S0022-5347(05)65974-5 - DOI - PubMed

Publication types