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Metastatic castration resistant prostate cancer with squamous cell, small cell, and sarcomatoid elements—a clinicopathologic and genomic sequencing-based discussion

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Abstract

Histologic variants are uncommon but well reported amongst cases of prostatic adenocarcinoma, including those in the setting of hormonal and/or chemoradiation therapy and castration resistance. However, the spectrum of morphologic phenotypes and molecular alterations present in such histologic variants are still incompletely understood. Herein, we describe a case of metastatic prostatic adenocarcinoma with hormonal and chemoradiation therapy-associated differentiation, displaying a combination of squamous cell, small cell, and sarcomatoid elements. The morphologic, immunohistochemical, and molecular observations are discussed with attention given to the gene alterations present, including in TP53, NF1, AR, PTEN, and RB1. Finally, we will compare our findings with those observed in uncommonly reported similar cases so as to detail the molecular underpinnings of such processes which may carry therapeutic implications.

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Authors and Affiliations

  1. Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, USA

    Steven C. Weindorf, Alexander S. Taylor, Chandan Kumar-Sinha, Dan Robinson, Yi-Mi Wu, Amir Lagstein, Arul M. Chinnaiyan & Rohit Mehra

  2. Department of Urology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA

    Arul M. Chinnaiyan

  3. Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI, USA

    Daniel E. Spratt & Michelle M. Kim

  4. Rogel Cancer Center, Michigan Medicine, 1400 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Daniel E. Spratt, Arul M. Chinnaiyan & Rohit Mehra

  5. Michigan Center for Translational Pathology, Ann Arbor, MI, USA

    Chandan Kumar-Sinha, Dan Robinson, Yi-Mi Wu, Xuhong Cao, Arul M. Chinnaiyan & Rohit Mehra

  6. Howard Hughes Medical Institute, Ann Arbor, MI, USA

    Arul M. Chinnaiyan

Authors
  1. Steven C. Weindorf
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  2. Alexander S. Taylor
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  3. Chandan Kumar-Sinha
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  4. Dan Robinson
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  7. Daniel E. Spratt
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  8. Michelle M. Kim
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Corresponding author

Correspondence to Rohit Mehra.

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Weindorf, S.C., Taylor, A.S., Kumar-Sinha, C. et al. Metastatic castration resistant prostate cancer with squamous cell, small cell, and sarcomatoid elements—a clinicopathologic and genomic sequencing-based discussion. Med Oncol 36, 27 (2019). https://doi.org/10.1007/s12032-019-1250-8

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  • DOI: https://doi.org/10.1007/s12032-019-1250-8

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