Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6388
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
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.
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.
Prostatic carcinosarcoma after adenocarcinoma is exceedingly rare. ADT mediated transformation and dedifferentiation of the epithelial components may be the origin of this malignancy.
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.