Large-cell neuroendocrine tumor of the prostate: a case report and review of the literature

Abstract

Background: Primitive neuroendocrine prostate neoplasms are rarely reported. This entity comprises carcinoïd tumors and poorly differentiated neuroendocrine tumors, mainly those of the small-cell type. Large-cell-type primitive tumors are exceptional, and only nine cases are reported in the literature. Similar to neuroendocrine tumors of the prostate, large-cell-type primitive tumors may be observed in the context of conventional adenocarcinoma during androgen deprivation therapy or as prostatic metastasis of a distant neuroendocrine tumor, mainly pulmonary neoplasms.

Case presentation: We report a Caucasian case of a mixed prostatic carcinoma, with the largest component being the large-cell neuroendocine carcinoma, in a patient who underwent a total prostatectomy for a localized cancer. Diagnostic, histological, therapeutic and evolutive aspects are reported and discussed.

Conclusions: Large-cell primitive prostate neuroendocrine carcinoma is a rare but aggressive histological entity, which can be associated or not with an adenocarcinomatous component. Mixed forms have a better outcome, mainly when diagnosed at an early stage.

Keywords: Local neoplasm recurrences; Neuroendocrine carcinoma; Prostate neoplasms; Prostatectomy.

Fig. 1

¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography: isolated metabolic uptake of the left lobe of the prostate

Fig. 2

Operative specimen from total prostatectomy: hematoxylin and eosin staining. Some small adenocarcinoma glands can be seen between clusters of the large-cell neuroendocrine component

Fig. 3

Operative specimen from total prostatectomy: immunohistochemistry. Positive labeling for chromogranin A (a) and synaptophysin (b). These two markers are positive for the neuroendocrine component and negative for the adenocarcinomatous component.