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
. 2021 Apr 23;16(1):35.
doi: 10.1186/s13000-021-01096-1.

Clinicopathologic features of metastatic small cell carcinoma of the prostate to the liver: a series of four cases

Phoenix D Bell  1 , Aaron R Huber  1 , Diana Agostini-Vulaj  2
Affiliations

Clinicopathologic features of metastatic small cell carcinoma of the prostate to the liver: a series of four cases

Phoenix D Bell et al. Diagn Pathol. .

Abstract

Background: Small cell neuroendocrine carcinoma of the prostate (SCNECP) is a rare, aggressive subtype of prostate carcinoma. Most SCNECP arise from conventional prostate adenocarcinoma (CPAC) treated with androgen deprivation therapy (ADT).

Case presentations: We identified four cases of CPAC treated with ADT, which evolved to SCNECP with liver metastasis. The average interval between the diagnosis of CPAC and SCNECP was 102 months (range: 12 to 168). Histologically, the tumors showed nests of cells with high nuclear:cytoplasmic ratios, granular chromatin, and frequent mitoses. All cases were synaptophysin, chromogranin, and AE1/AE3 positive, with a Ki-67 labeling index ≥70%. NKX3.1 was negative in all but one case and TTF-1 was positive in half. Weak ERG positivity by IHC was seen in one case which also demonstrated the TMPRSS2-ERG gene rearrangement; all other cases were negative for ERG by IHC. Serum prostate specific antigen (PSA) levels were normal to near-normal in all. The median interval between the diagnosis of SCNECP and death was 3.25 months (range: 0.75 to 26).

Conclusions: Our case series highlights the importance of considering a prostate primary, even in the setting of normal PSA levels and loss of prostate markers, when diagnosing neuroendocrine carcinoma in the liver. Further, we emphasize the significance of diagnosing SCNECP that metastasizes to the liver, as it portends a particularly dismal prognosis.

Keywords: Androgen deprivation therapy; Case series; Liver metastasis; Prostate; Small cell neuroendocrine carcinoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Liver mass biopsy a infiltration of liver parenchyma by cells arranged in nests and trabeculae [H&E, 40x], b area of central necrosis [H&E, 200x], c cells with high N:C, granular chromatin, inconspicuous nucleoli, and frequent mitoses
Fig. 2
Fig. 2
Immunohistochemistry a Synaptophysin [100x], b Chromogranin [100x], c AE1/AE3 [100x], d Ki-67 labeling index [100x]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. W. Wang and J. I. Epstein, “Small cell carcinoma of the prostate: a morphologic and immunohistochemical study of 95 cases,” Am J Surg Pathol., 2008, doi: 10.1097/PAS.0b013e318058a96b. - PubMed
    1. J. Wang et al., “Low-serum prostate-specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer,” Prostate, 2019, doi: 10.1002/pros.23878. - PubMed
    1. S. W. Fine, “Neuroendocrine tumors of the prostate,” Mod. Pathol., 2018, doi: 10.1038/modpathol.2017.164. - PubMed
    1. D. M. Marcus, M. Goodman, A. B. Jani, A. O. Osunkoya, and P. J. Rossi, “A comprehensive review of incidence and survival in patients with rare histological variants of prostate cancer in the United States from 1973 to 2008,” Prostate Cancer Prostatic Dis., 2012, doi: 10.1038/pcan.2012.4. - PubMed
    1. H. Moch, P. A. Humphrey, T. M. Ulbright, and V. E. Reuter, “WHO classification of tumours of the urinary system and male genital organs,” World Heal. Organ. classifcation tumours., 2016. - PubMed

MeSH terms

Substances