Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1630
Peer-review started: August 1, 2021
First decision: November 7, 2021
Revised: November 14, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 16, 2022
Processing time: 193 Days and 21.3 Hours
Small-cell carcinoma of the prostate (SCCP) is a clinically rare malignant tumor, accounting for < 1% of all prostate tumors. However, negativity for all SCCP neuroendocrine markers is rare. Herein, we report a case of SCCP with completely negative neuroendocrine markers and explore its clinicopathologic features, thus improving the understanding of its clinical diagnosis and management.
We report the case of a 48-year-old patient with SCCP negative for common sensitive neuroendocrine-staining indicators. Dysuria was the first symptom, and rectal examination revealed a hard prostate, palpable nodules, diffuse prostate enlargement, no pressure pain, no blood staining in the finger sleeve, 1.33 ng/mL total prostate-specific antigen level, and a free-to-total prostate-specific antigen ratio of 0.21 ng/mL. Ultrasound suggested a prostate size of 5.3 cm × 5.8 cm × 5.6 cm, and magnetic resonance imaging suggested prostate cancer. The lower posterior bladder wall, rectal mesentery, and bilateral seminal vesicles were invaded, with multiple lymph node metastases in the pelvis. A whole-body bone scan suggested an abnormally active multiple bone metabolism and possible bone metastases. Head and lungs computed tomography revealed no significant nodal shadow. Following a pathological diagnosis of SCCP after a prostate puncture, with negative indicators of common sensitive neuroendocrine staining, chemotherapy was administered; the patient died 4-5 mo after SCCP diagnosis.
SCCP is a rare disease characterized by atypical clinical symptoms, limited treatment options, a short survival period, and a poor prognosis.
Core Tip: Small cell carcinoma of the prostate (SCCP) is a very rare type of prostate tumor, generally characterized by low differentiation, high malignancy, rapid growth, easy diffusion, and poor prognosis. Among SCCP types, mixed SCCP is relatively common, completely simple SCCP is rarely reported, and SCCP with negative neuroendocrine markers is even rarer. This study reports a rare case of SCCP with completely negative neuroendocrine markers, and it found SCCP to be characterized by atypical clinical symptoms, limited treatment options, a short survival period, and a poor prognosis, requiring pathological examination to confirm its diagnosis.