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Characteristics of BRCA2 Mutated Prostate Cancer at Presentation. Int J Mol Sci 2022; 23:ijms232113426. [PMID: 36362213 PMCID: PMC9659116 DOI: 10.3390/ijms232113426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Genetic alterations of DNA repair genes, particularly BRCA2 in patients with prostate cancer, are associated with aggressive behavior of the disease. It has reached consensus that somatic and germline tests are necessary when treating advanced prostate cancer patients. Yet, it is unclear whether the mutations are associated with any presenting clinical features. We assessed the incidences and characteristics of BRCA2 mutated cancers by targeted sequencing in 126 sets of advanced prostate cancer tissue sequencing data. At the time of diagnosis, cT3/4, N1 and M1 stages were 107 (85%), 54 (43%) and 35 (28%) samples, respectively. BRCA2 alterations of clinical significance by AMP/ASCO/CAP criteria were found in 19 of 126 samples (15.1%). The BRCA2 mutated cancer did not differ in the distributions of TNM stage, Gleason grade group or histological subtype compared to BRCA2 wild-type cancers. Yet, they had higher tumor mutation burden, and higher frequency of ATM and BRCA1 mutations (44% vs. 10%, p = 0.002 and 21% vs. 4%, p = 0.018, respectively). Of the metastatic subgroup (M1, n = 34), mean PSA was significantly lower in BRCA2 mutated cancers than wild-type (p = 0.018). In the non-metastatic subgroup (M0, n = 64), PSA was not significantly different (p = 0.425). A similar trend was noted in multiple metastatic prostate cancer public datasets. We conclude that BRCA2 mutated metastatic prostate cancers may present in an advanced stage with relatively low PSA.
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Netto GJ, Amin MB, Berney DM, Compérat EM, Gill AJ, Hartmann A, Menon S, Raspollini MR, Rubin MA, Srigley JR, Hoon Tan P, Tickoo SK, Tsuzuki T, Turajlic S, Cree I, Moch H. The 2022 World Health Organization Classification of Tumors of the Urinary System and Male Genital Organs-Part B: Prostate and Urinary Tract Tumors. Eur Urol 2022; 82:469-482. [PMID: 35965208 DOI: 10.1016/j.eururo.2022.07.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/03/2022] [Indexed: 12/14/2022]
Abstract
The 2022 World Health Organization (WHO) classification of the urinary and male genital tumors was recently published by the International Agency for Research on Cancer. This fifth edition of the WHO "Blue Book" offers a comprehensive update on the terminology, epidemiology, pathogenesis, histopathology, diagnostic molecular pathology, and prognostic and predictive progress in genitourinary tumors. In this review, the editors of the fifth series volume on urologic and male genital neoplasms present a summary of the salient changes introduced to the classification of tumors of the prostate and the urinary tract.
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Affiliation(s)
- George J Netto
- Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Urology, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Daniel M Berney
- Barts Cancer Institute, Queen Mary University of London, London, UK; Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Eva M Compérat
- Department of Pathology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - Anthony J Gill
- Sydney Medical School, University of Sydney, Sydney, Australia; NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital St Leonards, Sydney, Australia; Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital St Leonards, Sydney, Australia
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Santosh Menon
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Maria R Raspollini
- Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy
| | - Mark A Rubin
- Department for BioMedical Research (DBMR), Bern Center for Precision Medicine (BCPM), University of Bern and Inselspital, Bern, Switzerland
| | - John R Srigley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, AichiMedicalUniversity Hospital, Nagakut, Japan
| | - Samra Turajlic
- The Francis Crick Institute and The Royal Marsden NHS Foundation Trust, London, UK
| | - Ian Cree
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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Jayasinghe KI, Abeysinghe AHMGB. Sarcomatoid carcinoma of the prostate presenting as bilateral cervical lymphadenopathy: a rare case report. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00274-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Sarcomatoid carcinoma (also called carcinosarcoma in the latest WHO classification 2016) of the prostate gland is a biphasic malignant neoplasm which exhibits epithelial and mesenchymal differentiation [1]. Sarcomatoid carcinoma is a rare tumour, considered as a variant of acinar adenocarcinoma in the WHO classification, with less than 200 reported cases in the literature to date [2]. Sarcomatoid carcinoma of prostate presenting with bilateral cervical lymph node deposits as the first clinical manifestation, is even rarer, and reported cases were not found in the literature; hence, this is the first case report of such, to the best of our knowledge.
Case presentation
We report a case of sarcomatoid carcinoma of the prostate in a 72-year-old Sri Lankan man who presented with bilateral cervical lymphadenopathy. He had hard nodular prostate on digital rectal examination (DRE). Ultrasound scan of abdomen (USS) revealed the presence of paraaortic lymphadenopathy, in addition. The excision biopsy of the right cervical lymph node revealed deposit of a carcinoma of epithelioid histomorphology, which showed patchy strong positivity for immunohistochemical marker (IHCm), PSA. His serum PSA value was 48 ng/ml (reference < 5.40 ng/ml). Contrast-enhanced computed tomography (CECT) showed mildly enlarged prostate gland with irregular outline, sclerotic lesions in cervico-thoracic and lumbosacral vertebrae and generalized lymphadenopathy. Transrectal ultrasound guided biopsy of the prostate revealed sarcomatoid carcinoma. Disseminated sarcomatoid carcinoma of prostate was diagnosed. The patient has undergone bilateral orchidectomy, marking a serum PSA value of 5.4 ng/ml two months thereafter. He is surviving for six months after diagnosis and is currently under chemotherapy with docetaxel for the disseminated disease.
Conclusion
Sarcomatoid carcinoma can present with cervical lymphadenopathy with absent lower urinary tract symptoms. In elderly patients with cervical lymphadenopathy, serum PSA, DRE and trans-rectal ultrasound scan are advocated to rule out prostate cancer. Immunohistochemical markers are required for the diagnosis of primary tumour and secondary deposit of sarcomatoid carcinoma of prostate.
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Wei W, Li QG, Long X, Hu GH, He HJ, Huang YB, Yi XL. Sarcomatoid carcinoma of the prostate with bladder invasion shortly after androgen deprivation: Two case reports. World J Clin Cases 2021; 9:1668-1675. [PMID: 33728311 PMCID: PMC7942028 DOI: 10.12998/wjcc.v9.i7.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To summarize the imaging, morphological and biological characteristics of sarcomatoid carcinoma (SC) of the prostate with bladder invasion not long after castration.
CASE SUMMARY Our two cases were initially diagnosed with adenocarcinoma of the prostate due to dysuria. However, prostate SC was diagnosed after transurethral resection of the prostate (TURP) and castration after only 5 and 10 mo, respectively. Distinctive liver-like tissues appeared in the second TURP procedure in case 1, while a white, fish flesh-like, narrow pedicled soft globe protruded from the prostate to the bladder in case 2.
CONCLUSION The sarcomatoid component of SC may arise from one of the specific groups of cancer cells that are resistant to hormonal therapy. Morphological characteristics of SCs can present as “red hepatization” and “fish flesh”. SCs grow rapidly and have a poor prognosis, and thus, extensive TURP plus radiation may be the treatment of choice.
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Affiliation(s)
- Wei Wei
- Department of Radiology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Qi-Guang Li
- Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Xian Long
- Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Gao-Hua Hu
- Department of Thyroid and Breast Surgery, Qichun People’s Hospital, Qichun 435300, Hubei Province, China
| | - Hua-Jie He
- Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yuan-Bi Huang
- Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Xian-Lin Yi
- Department of Urology, Cancer Hospital of Guangxi Medical University & Guangxi Cancer Research Institute, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Rebello RJ, Oing C, Knudsen KE, Loeb S, Johnson DC, Reiter RE, Gillessen S, Van der Kwast T, Bristow RG. Prostate cancer. Nat Rev Dis Primers 2021. [PMID: 33542230 DOI: 10.1038/s41572-020-0024.3-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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Affiliation(s)
- Richard J Rebello
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
| | - Christoph Oing
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
- Department of Oncology, Haematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Centre Eppendorf, Hamburg, Germany
| | - Karen E Knudsen
- Sidney Kimmel Cancer Center at Jefferson Health and Thomas Jefferson University, Philadelphia, PA, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, Manhattan, NY, USA
| | - David C Johnson
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Robert E Reiter
- Department of Urology, Jonssen Comprehensive Cancer Center UCLA, Los Angeles, CA, USA
| | | | - Theodorus Van der Kwast
- Laboratory Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Canada
| | - Robert G Bristow
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK.
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6
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Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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7
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Selvaraj N, Ragavan N, Shah SN. Carcinosarcoma of the Prostate Masquerading as Benign Prostatic Enlargement: Lesson Learned. EUR UROL SUPPL 2020; 23:9-12. [PMID: 34337484 PMCID: PMC8317776 DOI: 10.1016/j.euros.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/25/2022] Open
Abstract
Primary carcinosarcoma of the prostate is an extremely rare and aggressive malignancy. We report a patient who presented with obstructive symptoms and without a history of radiation, prior adenocarcinoma, or androgen deprivation therapy. Transurethral resection of the prostate was performed. Histopathology and immunohistochemistry revealed a confirmatory diagnosis of de novo carcinosarcoma of the prostate. The case is described for its rarity and masquerading nature.
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8
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Al-Saadi N, Al-Musawi S, Khan Y, Dawam D. An unusual presentation of prostate cancer posing a diagnostic dilemma: A case report. Urol Case Rep 2020; 34:101432. [PMID: 33088717 PMCID: PMC7558784 DOI: 10.1016/j.eucr.2020.101432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 11/24/2022] Open
Abstract
Sarcomatoid carcinomas are a rare type of prostate cancer and are associated with a poor prognosis. We present the case of an 80-year-old gentleman who presented with rectal bleeding and his CT scan revealed an incidental pelvic cystic mass. He initially underwent attempted ultrasound-guided drainage and transurethral resection for this. Definitive management was a radical surgery. Histological findings confirmed that the morphological features favoured a sarcomatoid prostate cancer rather than a primary sarcoma, as was thought. Unusual presentations of pathologies may be encountered during our practice and present a challenge. A methodological approach is required to ensure positive outcomes.
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Affiliation(s)
| | | | - Yousuf Khan
- Southend University Hospital, United Kingdom
| | - Daben Dawam
- Southend University Hospital, United Kingdom
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9
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Yong C, Moose DL, Bannick N, Gutierrez WR, Vanneste M, Svensson R, Breheny P, Brown JA, Dodd RD, Cohen MB, Henry MD. Locally invasive, castrate-resistant prostate cancer in a Pten/Trp53 double knockout mouse model of prostate cancer monitored with non-invasive bioluminescent imaging. PLoS One 2020; 15:e0232807. [PMID: 32986721 PMCID: PMC7521703 DOI: 10.1371/journal.pone.0232807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/10/2020] [Indexed: 11/18/2022] Open
Abstract
Here we have improved an existing mouse model of prostate cancer based on prostate-specific deletion of Pten and Trp53 by incorporating a Cre-activatable luciferase reporter. By coupling the deletion of those genes to the activation of a luciferase reporter, we were able to monitor tumor burden non-invasively over time. We show that, consistent with previous reports, deletion of both Pten and Trp53 on a C57BL/6 background accelerates tumor growth and results in both the loss of androgen receptor expression and castrate resistant tumors as compared with loss of Pten alone. Loss of Trp53 results in the development of sarcomatoid histology and the expression of markers of epithelial-to-mesenchymal transition Zeb1 and vimentin, with kinetics and penetrance dependent on whether one or both alleles of Trp53 were deleted. Homozygous deletion of Trp53 and Pten resulted in uniformly lethal disease by 25 weeks. While we were able to detect locally invasive disease in the peritoneal cavity in aggressive tumors from the double knockout mice, we were unable to detect lymphatic or hematogenous metastatic disease in lymph nodes or at distant sites.
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Affiliation(s)
- Courtney Yong
- Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Devon L Moose
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Nadine Bannick
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Wade R Gutierrez
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.,Medical Scientist Training Program, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Marion Vanneste
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Robert Svensson
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Patrick Breheny
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States of America
| | - James A Brown
- Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
| | - Rebecca D Dodd
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States of America
| | - Michael B Cohen
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Michael D Henry
- Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.,Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States of America.,Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America.,Department of Radiation Oncology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
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10
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Zhao S, Komori T, Inoue A, Aoki M, Matsushita S. Rare case of sarcomatoid carcinoma of the prostate with metastatic skin tumor manifestation. J Dermatol 2020; 47:e304-e305. [PMID: 32515114 DOI: 10.1111/1346-8138.15426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Shuang Zhao
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.,Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Takaya Komori
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.,Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akiha Inoue
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.,Department of Dermatology, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Megumi Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
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11
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Aggarwal S, Mitra S, Dewan A, Durga G. Carcinosarcoma prostate with osteosarcomatous differentiation: a rare de novo presentation. BMJ Case Rep 2019; 12:12/6/e230116. [PMID: 31196973 DOI: 10.1136/bcr-2019-230116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Carcinosarcoma is a rare histological event in the history of prostatic malignancies. Historically aggressive tumours with dismal outcomes reported in scarce literature available so far. Very few recent studies suggest good outcomes with modern era surgery and radiotherapy techniques in localised disease. The case presented here had no history of known risk factors like prior adenocarcinoma or prior radiation therapy. This case presented with obstructive urinary symptoms with no prostate-specific antigen elevation, diagnosed with imaging, managed aggressively with robotic surgery. Detailed immunohistochemistry and pathological review suggested diagnosis as carcinosarcoma with osteosarcomatous differentiation. Very rare such cases were reported in the past with complete clinical, radiological, pathological details and managed aggressively with good outcomes. The patient is disease free after 6 months of follow-up.
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Affiliation(s)
- Sumeet Aggarwal
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Swarupa Mitra
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Abhinav Dewan
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Garima Durga
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
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12
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Apatinib-based targeted therapy against pulmonary sarcomatoid carcinoma: a case report and literature review. Oncotarget 2018; 9:33734-33738. [PMID: 30263099 PMCID: PMC6154744 DOI: 10.18632/oncotarget.25989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/17/2018] [Indexed: 12/15/2022] Open
Abstract
Sarcomatoid carcinoma is a rare malignancy characterized by a combination of epithelial and sarcoma or sarcoma-like components. In this study, we reported one case of pulmonary sarcomatoid carcinoma and evaluated the safety and efficacy of apatinib, a tyrosine kinase inhibitor selectively targeting vascular endothelial growth factor receptor 2, in treating this disease. The tumor mass was detected in the left lung of a 75-year-old man and showed positive immunostaining for cytokeratin (CK) 7, CK8, smooth muscle actin, CD31, and CD34. Next-generation sequencing analysis identified 4 mutations in NF1 (p.Q347Sfs*29), CDKN2A (p.G23V), ERBB3 (p.V104L), and TP53 (p.V157F) genes. The patient was given apatinib (250 mg) orally once per day. Sustained tumor regression was observed after apatinib treatment. There was no sever complication associated with apatinib therapy. In conclusion, apatinib-based targeted therapy may represent an important option for patients with sarcomatoid carcinoma.
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13
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Kan A, Guo RP. The prognosis of subsequent surgical treatment in patients with sarcomatoid carcinoma in the liver: A retrospective study. Int J Surg 2018; 55:145-151. [PMID: 29860126 DOI: 10.1016/j.ijsu.2018.05.736] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/01/2018] [Accepted: 05/27/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sarcomatoid hepatocellular carcinoma (SHC) is a rare disease with a poor prognosis. Due to the scarcity of patients with this condition, the optimal treatment for SHC has not been established. In this study, we compared the benefits of subsequent treatments for surgical SHC patients. MATERIALS AND METHODS Clinical records were retrospectively studied. The SHC patients were divided into two groups according to whether subsequent treatment was performed. The overall survival (OS) rates and disease-free survival (DFS) rates were estimated by the Kaplan-Meier method, and comparisons were made using the log-rank test. Univariate and multivariate analyses were evaluated using the Cox proportional hazards regression model. RESULTS The study included 25 patients; 9 (36%) had subsequent treatments following surgery. The median OS of the treatment group and non-treatment group were 8.8 months [95% confidence interval (CI) 8.4-9.1] and 5.4 months [95% CI 4.3-6.5], respectively. OS showed statistical significance between the two groups (log-rank, P = 0.025). Univariate analysis suggested that two factors were poor predictors of OS: without subsequent treatment and with capsule formation. Multivariate analysis demonstrated that only subsequent treatment significantly influenced OS. CONCLUSION After surgery, SHC patients with subsequent treatment showed better outcomes. However, a more effective treatment is yet to be found. Further studies with a larger patient population are needed.
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Affiliation(s)
- Anna Kan
- Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Rong-Ping Guo
- Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
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14
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Inamura K. Prostatic cancers: understanding their molecular pathology and the 2016 WHO classification. Oncotarget 2018; 9:14723-14737. [PMID: 29581876 PMCID: PMC5865702 DOI: 10.18632/oncotarget.24515] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/12/2018] [Indexed: 12/12/2022] Open
Abstract
Accumulating evidence suggests that prostatic cancers represent a group of histologically and molecularly heterogeneous diseases with variable clinical courses. In accordance with the increased knowledge of their clinicopathologies and genetics, the World Health Organization (WHO) classification of prostatic cancers has been revised. Additionally, recent data on their comprehensive molecular characterization have increased our understanding of the genomic basis of prostatic cancers and enabled us to classify them into subtypes with distinct molecular pathologies and clinical features. Our increased understanding of the molecular pathologies of prostatic cancers has permitted their evolution from a poorly understood, heterogeneous group of diseases with variable clinical courses to characteristic molecular subtypes that allow the implementation of personalized therapies and better patient management. This review provides perspectives on the new 2016 WHO classification of prostatic cancers as well as recent knowledge of their molecular pathologies. The WHO classification of prostatic cancers will require additional revisions to allow for reliable and clinically meaningful cancer diagnoses as a better understanding of their molecular characteristics is obtained.
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Affiliation(s)
- Kentaro Inamura
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
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15
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Vulvar Carcinosarcoma Composed of Intestinal-type Mucinous Adenocarcinoma Associated With Anaplastic Pleomorphic and Spindle Cell Carcinoma and Heterologous Chondrosarcomatous and Osteosarcomatous Elements. Int J Gynecol Pathol 2018; 37:93-100. [DOI: 10.1097/pgp.0000000000000385] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Abstract
This review focuses on histopathological aspects of carcinoma of the prostate. A tissue diagnosis of adenocarcinoma is often essential for establishing a diagnosis of prostate cancer, and the foundation for a tissue diagnosis is currently light microscopic examination of hematoxylin and eosin (H&E)-stained tissue sections. Markers detected by immunohistochemistry on tissue sections can support a diagnosis of adenocarcinoma that is primary in the prostate gland or metastatic. Histological variants of carcinoma of the prostate are important for diagnostic recognition of cancer or as clinicopathologic entities that have prognostic and/or therapeutic significance. Histological grading of adenocarcinoma of the prostate, including use of the 2014 International Society of Urological Pathology (ISUP) modified Gleason grades and the new grade groups, is one of the most powerful prognostic indicators for clinically localized prostate cancer, and is one of the most critical factors in determination of management of these patients.
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Affiliation(s)
- Peter A Humphrey
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06437
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17
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Sarcomatoid carcinoma associated with small cell carcinoma of the urinary bladder: a series of 28 cases. Hum Pathol 2017; 67:169-175. [DOI: 10.1016/j.humpath.2017.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/24/2017] [Accepted: 08/10/2017] [Indexed: 11/24/2022]
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18
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Characterization of a new murine cell line of sarcomatoid hepatocellular carcinoma and its application for biomarker/therapy development. Sci Rep 2017; 7:3052. [PMID: 28596515 PMCID: PMC5465177 DOI: 10.1038/s41598-017-03164-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/21/2017] [Indexed: 02/06/2023] Open
Abstract
Sarcomatoid hepatocellular carcinoma (SHC) is a rare type of HCC with significantly poorer survival than ordinary HCC. Little is known about the mechanism associated with SHC and its biomarkers and therapy. Here, we established a mouse liver cancer cell line and designated as Ymac-1. A sarcomatous appearance was observed in the allograft tumor arose from Ymac-1. Liver-secreted plasma proteins were found in Ymac-1 cultured supernatant by proteomics analysis. The positive staining of CK7, CK8, Vimentin and the suppressed expression of AFP indicated that Ymac-1 is a SHC cell line. Compared to its original tumor, an elevated level of EMT markers, N-cadherin and Vimentin, was found in Ymac-1. Ymac-1 displayed a higher migration rate and side population percentage than a mouse ordinary HCC cell line-Hepa1-6. Microarray analysis was performed to identify potential biomarkers/therapeutic targets for SHC. G6pd, a vital enzyme in pentose phosphate pathway, is highly expressed in Ymac-1. Depletion of G6pd in Ymac-1 reduced CD133 expression and sphere formation. Positive correlations between G6PD and CD133 were observed in human specimen. Higher expression of both G6PD and CD133 in tumor were associated with poor survival. In summary Ymac-1 can be a useful SHC cell model for novel biomarker and therapy development.
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19
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Acosta AM, Senseng C, Kim G, Sekosan M, Ree N. Sarcomatoid carcinoma of the prostate with adenocarcinoma, squamous cell carcinoma, and heterologous components. APMIS 2016; 124:719-22. [PMID: 27197712 DOI: 10.1111/apm.12548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/05/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Andres Martin Acosta
- Department of Pathology, University of Illinois at Chicago Hospital and Health Sciences System, Chicago, IL.
| | - Carmencita Senseng
- Department of Pathology, John H. Stroger Jr Hospital of Cook County (CCHS), Chicago, IL
| | - George Kim
- Department of Pathology, John H. Stroger Jr Hospital of Cook County (CCHS), Chicago, IL
| | - Marin Sekosan
- Department of Pathology, John H. Stroger Jr Hospital of Cook County (CCHS), Chicago, IL
| | - Nicholas Ree
- Department of Pathology, John H. Stroger Jr Hospital of Cook County (CCHS), Chicago, IL
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20
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Chen W, Han DJ, Fu GQ, Lin W, Liang Y. Long term follow-up of surgery management of prostate leiomyosarcoma metastasized to the rib: A case report and literature review. Mol Clin Oncol 2016; 5:132-134. [PMID: 27330784 DOI: 10.3892/mco.2016.898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/01/2016] [Indexed: 11/05/2022] Open
Abstract
Prostate sarcoma, particularly the pathological type of leiomyosarcoma, is a rare carcinoma, which originated from the interstitial tissue of the prostate. This sarcoma type has a poor prognosis. This disease accounts for ~0.1% of all prostate cancer and it usually occurrs in patients aged between 40 and 78-years-old. Although prostate leiomyosarcoma has a poor prognosis, early treatment of post-operative recurrence and metastases via a whole-body examination and closer follow-up was possible. These measurements may significantly prolong the survival time and improve the quality of life. The present study reported a successful case of surgical management for prostate leiomyosarcoma in the Zigong No. 4 People's Hospital (Sichuan, China) during 1995 until 2015, with post-operative follow-up for 20 years.
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Affiliation(s)
- Wei Chen
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Deng-Jun Han
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Guang-Qing Fu
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Wei Lin
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Yong Liang
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
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