Background: Small cell carcinoma (SCC) of the prostate represents a rare form of prostatic carcinoma. While the tumor is often considered to arise from neuroendocrine proliferation or possibly dedifferentiation of an acinar carcinoma, the precise etiology remains uncertain. The diagnosis of prostatic SCC in urine has to date not been described. Methods: A retrospective review was performed at a tertiary-care hospital, and 3 patients with prostatic SCC in voided urinary specimens were identified. The following clinical data were collected for each case: age, gender, treatment and follow-up information, when available. Results: The patient age range was 70-86 years, all male. Two patients had known metastatic adenocarcinoma of the prostate, and 1 had recently presented with prostatic SCC. One patient with metastatic disease died shortly after diagnosis, the other was lost to follow-up. The third patient with a recent presentation has yet to have a treatment plan finalized. Conclusions: Our results highlight the importance of making this uncommon diagnosis as it may carry significant treatment and prognostic importance. Future work should hopefully clarify the role of ERG gene rearrangements in the pathogenesis of prostatic SCC, as there is a potential role here for targeted therapy.

Keywords:
Prostate, Small cell carcinoma, Urine diagnosis
1.
Ali SZ, Reuter VE, Zakowski MF: Small cell neuroendocrine carcinoma of the urinary bladder: a clinicopathologic study with emphasis on cytologic features. Cancer 1997;79:356-361.
2.
Richardson RL, Weiland LH: Undifferentiated small cell carcinomas in extrapulmonary sites. Semin Oncol 1982;9:484-496.
3.
Gould VE, Banner BF, Baerwaldt M: Neuroendocrine neoplasms in unusual primary sites. Diagn Histopathol 1981;4:263-277.
4.
Furtado P, Lima MVA, Nogueira C, Franco M, Tavora F: Review of small cell carcinomas of the prostate. Prostate Cancer 2011;2011:543272.
5.
Abbas F, Civantos F, Benedetto P, Soloway MS: Small cell carcinoma of the bladder and prostate. Urology 1995;46:617-630.
6.
Brownback KR, Renzulli J, Myers JR: Small-cell prostate carcinoma: a retrospective analysis of five newly reported cases. Indian J Urol 2009;25:259-263.
7.
Rubenstein JH, Katin MJ, Mangano MM, Dauphin J, Salenius SA, Dosoretz DE, Blitzer PH: Small cell anaplastic carcinoma of the prostate: seven new cases, review of the literature and discussion of a therapeutic strategy. Am J Clin Onc 1997;20:376-380.
8.
Anker CJ, Dechet C, Isaac JC, Akerley W: Small cell carcinoma of the prostate. JCO 2007;14:1168-1171.
9.
Abrahamsson PA: Neuroendocrine differentiation in prostatic carcinoma. Prostate 1999;39:135-148.
10.
Papandreou CN, Daliani DD, Thall PF, Tu SM, Wang X, Reyes A, Troncoso P, Logothetis CJ: Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate. J Clin Oncol 2002;20:3072-3080.
11.
Bolton DM, Chiu ST, Clarke S, Angus D: Primary small cell carcinoma of the prostate: unusual modes of presentation. Aust N Z J Surg 1994;64:91-94.
12.
Hindson DA, Knight LL, Ocker JM: Small-cell carcinoma of prostate. Transient complete remission with chemotherapy. Urology 1985;26:182-184.
13.
Tetu B, Ro JY, Ayala AG, Johnson DE, Logothetis CJ, Ordonez NG: Small cell carcinoma of the prostate. Part I. A clinicopathologic study of 20 cases. Cancer 1987;59:1803-1809.
14.
Moore SR, Reinberg Y, Zhang G: Small cell carcinoma of prostate: effectiveness of hormonal versus chemotherapy. Urology 1992;39:411-416.
15.
Spiess PE, Pettaway CA, Vakar-Lopez F, Kassouf W, Wang X, Busby JE, Do KA, Davuluri R, Tannir NM: Treatment outcomes of small cell carcinoma of the prostate: a single-center study. Cancer 2007;110:1729-1737.
16.
Parwani AV, Sli SZ: Prostatic adenocarcinoma metastases mimicking small cell carcinoma on fine-needle aspiration. Diagn Cytopathol 2002;27:75-79.
17.
Guo CC, Dancer JY, Wang Y, Aparicio A, Navone NM, Troncoso P, Czerniak BA: TMPRSS2-ERG gene fusion in small cell carcinoma of the prostate. Hum Pathol 2011;42:11-17.
18.
Lotan TL, Gupta NS, Wang W, Toubaji A, Haffner MC, Chaux A, Hicks JL, Meeker AK, Bieberich CJ, DeMarzo AM, Epstein JI, Netto GJ: ERG gene rearrangements are common in prostatic small cell carcinomas. Mod Pathol 2011;24:820-828.
19.
Han B, Mehra R, Suleman K, et al: Characterization of ETS gene aberrations in select histologic variants of prostate carcinoma. Mod Pathol 2009;22:1176-1185.
20.
Williamson SR, Zhang S, Yao JL, Huang J, Lopez-Beltran A, Shen S, Osunkoya AO, MacLennan GT, Montironi R, Cheng L: ERG-TMPRSS2 rearrangement is shared by concurrent prostatic adenocarcinoma and prostatic small cell carcinoma and absent in small cell carcinoma of the urinary bladder: evidence supporting monoclonal origin. Mod Pathol 2011;24:1120-1127.
21.
Fine SW, Gopalan A, Leversha MA, Al-Ahmadie HA, Tickoo SK, Zhou Q, Satagopan JM, Scardino PT, Gerald WL, Reuter VE: TMPRSS2-ERG gene fusion is associated with low Gleason scores and not with high-grade morphological features. Mod Pathol 2010;23:1325-1333.
22.
Gopalan A, Leversha MA, Satagopan JM, Zhou Q, Al-Ahmadie HA, Fine SW, Eastham JA, Scardino PT, Scher HI, Tickoo SK, Reuter VE, Gerald WL: TMPRSS2-ERG gene fusion is not associated with outcome in patients treated by prostatectomy. Cancer Res 2009;69:1400-1406.
23.
Brenner JC, Ateeq B, Li Y, Yocum AK, Cao Q, Asangani IA, Patel S, Wang X, Liang H, Yu J, Palanisamy N, Siddiqui J, Yan W, Cao X, Mehra R, Sabolch A, Basrur V, Lonigro RJ, Yang J, Tomlins SA, Maher CA, Elenitoba-Johnson KS, Hussain M, Navone NM, Pienta KJ, Varambally S, Feng FY, Chinnaiyan AM: Mechanistic rationale for inhibition of poly (ADP-ribose) polymerase in ETS gene fusion-positive prostate. Cell 2011;19:664-678.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.