Aggressive variant prostate cancer: A case report and literature review

Figure 1 Magnetic resonance imaging after transurethral resection of the prostate and androgen deprivation therapy for 4 mo. A: The prostate signal was uneven, and the boundary between the central zone and peripheral zone was not clear. The boundary between the prostate and the posterior wall of the bladder was not clear locally; B: Poor visualization of bilateral seminal vesicle glands.

Figure 2 Bone emission computed tomography images in castration-resistant prostate cancer. A: The left iliac crest, left acetabulum, left superior ramus of the pubis, and right inferior ramus of the pubis had abnormal metabolism; B: An approximately 1 mm nodule was seen in the middle lobe of the right lung, and pulmonary metastasis was considered.

Figure 3 Pathological examination of the prostate mass in December 2020. A: Prostate puncture of the left lobe, adenocarcinoma of the prostate. Gleason: 4 + 4 = 8. Immunohistochemical results: P36 and 34βE12 (showing loss of myoepithelium), α-Methylacyl CoA racemase (P504S) (+), prostate specific acid phosphatase (+), androgen receptor (+); B: Prostate puncture of the right lobe. Gleason: 4 + 4 = 8.

Figure 4 Brain magnetic resonance imaging in February 2022. The mass in the left frontal lobe was approximately 2.6 cm in diameter, with a distinct band of surrounding edema. A: Median sagittal section of brain magnetic resonance imaging (MRI); B: Transverse section of brain MRI.

Figure 5 The third biopsy of the prostate mass in February 2022. A: Prostate puncture of the left lobe, adenocarcinoma of the prostate. Gleason: 4 + 4 = 8. Immunohistochemical results: Prostate specific acid phosphatase (a few weak +), P63 (myoepithelial disappearance), α-Methylacyl CoA racemase (P504S) (partly + +), high molecular weight cytokeratin (myoepithelial disappearance), androgen receptor (+), neuro-specific enolase (-), neural cell adhesion molecule (CD56) (-), synaptophysin (-), Chromogranin A (individually +), tumor proliferation antigen (Ki67) (20% +); B: Prostate puncture of the right lobe.