Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1668
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
To summarize the imaging, morphological and biological characteristics of sarcomatoid carcinoma (SC) of the prostate with bladder invasion not long after castration.
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.
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.
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.