Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6388-6392
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6388
Prostatic carcinosarcoma seven years after radical prostatectomy and hormonal therapy for prostatic adenocarcinoma: A case report
Xiao Huang, Song-Liang Cai, Li-Ping Xie
Xiao Huang, Song-Liang Cai, Li-Ping Xie, Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310030, Zhejiang Province, China
Author contributions: Huang X analyzed the data and wrote the manuscript; Cai SL performed the surgery and collected the data; Xie LP contributed to manuscript reviewing; all authors have read and approved the final manuscript.
Supported by the Natural Science Foundation of Zhejiang Province, China, No. LY19H050008.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao Huang, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310030, Zhejiang Province, China. xiaohuang69@zju.edu.cn
Received: January 10, 2021
Peer-review started: January 10, 2021
First decision: February 11, 2021
Revised: February 28, 2021
Accepted: June 16, 2021
Article in press: June 16, 2021
Published online: August 6, 2021
Abstract
BACKGROUND

Prostatic carcinosarcoma is a very rare and highly aggressive tumor. It may occur after androgen deprivation therapy (ADT) for adenocarcinoma even after a 7-year interval.

CASE SUMMARY

A 66-year-old man presented with recurrent symptoms of gross hematuria and urinary retention. The patient had a previous history of combined radical prostatectomy and ADT for prostate cancer 7 years prior. He received total pelvic exenteration for a recurrent pelvic carcinosarcoma. Pathology and immunostaining revealed a carcinosarcoma of prostatic origin with focal spindled cells and bizarre giant cells. The patient subsequently underwent transverse colostomy for carcinosarcoma recurrence and bowel obstruction 3 mo later. Five months after the diagnosis of prostatic carcinosarcoma, the patient died of multiple organ metastases.

CONCLUSION

Prostatic carcinosarcoma after adenocarcinoma is exceedingly rare. ADT mediated transformation and dedifferentiation of the epithelial components may be the origin of this malignancy.

Keywords: Prostate cancer, Adenocarcinoma, Carcinosarcoma, Sarcomatoid carcinoma, Radical prostatectomy, Androgen deprivation therapy, Case report

Core Tip: This is an unusual case of delayed occurrence of prostatic carcinosarcoma 7 years after radical prostatectomy and androgen deprivation therapy (ADT) for prostatic adenocarcinoma. It is very uncommon for a patient to have both neoplasms. ADT mediated transformation and dedifferentiation of the epithelial component may be the origin of this malignancy.