Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1668-1675
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1668
Sarcomatoid carcinoma of the prostate with bladder invasion shortly after androgen deprivation: Two case reports
Wei Wei, Qi-Guang Li, Xian Long, Gao-Hua Hu, Hua-Jie He, Yuan-Bi Huang, Xian-Lin Yi
Wei Wei, Department of Radiology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Qi-Guang Li, Xian Long, Hua-Jie He, Yuan-Bi Huang, Xian-Lin Yi, Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Gao-Hua Hu, Department of Thyroid and Breast Surgery, Qichun People’s Hospital, Qichun 435300, Hubei Province, China
Author contributions: Wei W, Li QG, and Long X are joint first authors; Yi XL, He HJ, Li QG, and Huang YB contributed to the study design; Yi XL, Wei W, and Hu GH contributed to acquisition, analysis and interpretation of data, drafting of the manuscript; and all authors have read and approved the final manuscript, and written consent for publication was obtained.
Supported by National Natural Science Foundation of China, No. 31860289.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: No competing interests.
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: Xian-Lin Yi, MD, PhD, Chief Physician, Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. yzztx@126.com
Received: September 17, 2020
Peer-review started: September 17, 2020
First decision: October 27, 2020
Revised: November 3, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: March 6, 2021
Abstract
BACKGROUND

To summarize the imaging, morphological and biological characteristics of sarcomatoid carcinoma (SC) of the prostate with bladder invasion not long after castration.

CASE SUMMARY

Our two cases were initially diagnosed with adenocarcinoma of the prostate due to dysuria. However, prostate SC was diagnosed after transurethral resection of the prostate (TURP) and castration after only 5 and 10 mo, respectively. Distinctive liver-like tissues appeared in the second TURP procedure in case 1, while a white, fish flesh-like, narrow pedicled soft globe protruded from the prostate to the bladder in case 2.

CONCLUSION

The sarcomatoid component of SC may arise from one of the specific groups of cancer cells that are resistant to hormonal therapy. Morphological characteristics of SCs can present as “red hepatization” and “fish flesh”. SCs grow rapidly and have a poor prognosis, and thus, extensive TURP plus radiation may be the treatment of choice.

Keywords: Sarcomatoid carcinoma, Prostate, Androgen deprivation, Bladder, Prostatic adenocarcinoma, Case report

Core Tip: The sarcomatoid component of prostate sarcomatoid carcinomas (SCs) may arise from one of the specific groups of cancer cells that are resistant to hormonal therapy. Morphological characteristics of the SCs can present as “red hepatization” and “fish flesh”. The SCs grow rapidly and have a poor prognosis, and thus, extensive transurethral resection of the prostate plus radiation may be the treatment of choice. Sarcomatoid components may be another pathway of lineage plasticity during prostate adenocarcinoma progression and therapy resistance.