Small cell carcinoma of the prostate: Molecular basis and clinical implications
Lisha Wang1,2, Darrell D. Davidson3, Rodolfo Montironi5, Antonio Lopez-Beltran6, Shaobo Zhang3, Sean R. Williamson7, Gregory T. MacLennan8, Chaofu Wang1,2, Mingsheng Wang3, Robert E. Emerson3, Xiang Du1,2 and Liang Cheng3,4
1Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China, 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China, 3Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA, 4Department of Urology, Indiana University School of Medicine, Indianapolis, IN USA, 5Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy, 6Department of Pathology, Cordoba University, Cordoba, Spain, 7Department of Pathology, Henry Ford Health System, Detroit, MI and 8Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
Offprint requests to: Dr. Liang Cheng, Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 West 11th Street, IU Health Pathology Laboratory Room 4010, Indianapolis, IN 46202, USA. e-mail: liang_cheng@yahoo.com; or Dr. Xiang Du, Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China. e-mail: dx2008cn@163.com
Summary. Small cell carcinoma of the prostate (PSCC) is a rare and highly aggressive malignancy with a dismal prognosis. Most patients present with advanced disease, including metastases to bone, viscera, and the central nervous system. Histologically, PSCC is indistin-guishable from its pulmonary counterpart. Although PSCC may occur in pure form, as in small cell lung carcinoma, it also occurs in conjunction with conventional glandular prostate carcinoma, and may evolve from conventional adenocarcinoma during the course of hormonal therapy. Immunohistochemical staining is extremely helpful in establishing the diagnosis, a prerequisite, as in small cell lung cancer, for optimal therapeutic strategy. Currently, combinations of surgical resection, chemotherapy, and radiation therapy represent the main treatment options. Improvement in survival may depend upon the identification of new molecular markers to facilitate earlier diagnosis and the development of novel targeted therapies. This review will discuss general aspects of PSCC, focusing on ways in which our understanding of PSCC has been advanced by studies of the histopathologic, immunohistochemical and molecular alterations in this disease. Histol Histopathol 30, 413-424 (2015)
Key words: Prostatic small cell carcinoma, Androgen receptor, TMPRSS2-ERG rearrangement, Clonal origin, Carcinogenesis, Differential diagnosis, Molecular cytogenetics
DOI: 10.14670/HH-30.413