Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center

• Autor(a) principal: Lima, M. V. A.
• Data de Publicação: 2011
• Outros Autores: Nogueira, C., Oliveira, J. A. A., Muniz Neto, F. J., Franco, M. [UNIFESP], Tavora, Fabio Rocha Fernandes [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S1677-55382011000500005; http://repositorio.unifesp.br/handle/11600/33991
• topic: prostate; neoplasms; carcinoid tumor; neuroendocrine tumor; treatment outcome

Purpose: Neuroendocrine carcinomas (NEC) of the prostate are rare, with only a few series hitherto reported. the objective of this study was to assess in a single institution the clinical and morphologic characteristics of neuroendocrine carcinomas diagnosed in needle core biopsies.Materials and Methods: the current study analyses seven cases diagnosed in needle biopsies at a large tertiary regional cancer center from Northeastern Brazil. Two pathologists reviewed specimens retrospectively, and demographic and morphologic characteristics were compared to 458 acinar tumors diagnosed in the same period.Results: There were five small cell carcinomas and two low-grade neuroendocrine carcinomas (carcinoid). NEC were associated with an acinar component in 5/7 cases and the Gleason score of the acinar component was always > 6. the number of cores involved in prostates with NEC was greater (65% compared to 24% of acinar tumors, p < 0.05). the mean PSA at diagnosis was 417.7 (range 5.7-1593, SD 218.3), compared to 100.5 (p = 0.1) of acinar tumors (range 0.3-8545, SD 22.7). Prostates harboring NEC were bigger (p < 0.001, mean volume 240 mL vs. 53 mL of acinar tumors). Treatment of NEC included palliative surgery, chemotherapy, and hormonal therapy.Conclusions: NEC of the prostate is rare and often associated with a high-grade acinar component. Prostates with NEC tend to be larger and involve a greater number of cores than acinar tumors. PSA at diagnosis does not seem to predict the presence of NE tumors in needle biopsy.