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Neuroendocrine and Small Cell Carcinomas of the Prostate: Sentinels of Lethal Evolution

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Rare Genitourinary Tumors

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Abstract

Neuroendocrine carcinomas and small cell carcinomas [NE/SCCs] encompass a broad range of neoplasms that arise from pulmonary and extra-pulmonary sites. Although pulmonary small cell carcinomas in smokers and the functional carcinoid tumors of the foregut associated with paraneoplastic endocrine syndromes are perhaps the best recognized of these diverse tumors, various organs can generate well-differentiated and poorly differentiated tumors from different cells of origin and with different genetic associations. In the prostate gland specifically, histopathological features distinguish high-grade poorly differentiated NE/SCCs from adenocarcinomas with Paneth cell differentiation and truly rare large cell neuroendocrine carcinomas and well-differentiated carcinoid tumors from other histological variants of prostatic neoplasms. For the diagnostic pathologist, immunohistochemical stains for neuroendocrine markers including chromogranin, neuron-specific enolase, CD56, and synaptophysin are useful and important adjuncts to light microscopic findings but are not strictly required for the diagnosis. For the clinician, the essential consideration is the awareness of the unique behavior and lethal potential of this entity which has major implications for management strategies. For the translational research scientist, the clonal origins and genetic traits associated with this tumor provide an essential window into the evolutionary biology of the disease through which integrated strategies toward prevention and therapy may be conceived.

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Acknowledgements

The authors would like to acknowledge Elizabeth Genega, MD for assistance with photography of representative pathology.

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Authors and Affiliations

  1. Division of Hematology-Oncology, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA

    John Paul Flores

  2. Division of Hematology-Oncology, Department of Medicine, Tufts University School of Medicine, Boston, MA, 02111, USA

    Paul Mathew MD

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  1. John Paul Flores
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Correspondence to Paul Mathew MD .

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Editors and Affiliations

  1. Department of Oncology, Mayo Clinic, Division of Medical Oncology, Rochester, Minnesota, USA

    Lance Pagliaro

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Flores, J.P., Mathew, P. (2016). Neuroendocrine and Small Cell Carcinomas of the Prostate: Sentinels of Lethal Evolution. In: Pagliaro, L. (eds) Rare Genitourinary Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-30046-7_13

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  • DOI: https://doi.org/10.1007/978-3-319-30046-7_13

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