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Oyogoa E, Sonpatki M, Brinkerhoff BT, Andeen N, Meyer H, Ryan C, Sokolova AO. Mixed Adenosquamous Cell Carcinoma of the Prostate with Paired Sequencing on the Primary and Liver Metastasis. Curr Oncol 2024; 31:2393-2399. [PMID: 38785459 PMCID: PMC11119923 DOI: 10.3390/curroncol31050178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 05/25/2024] Open
Abstract
This report aims to shed light on the intricate challenges encountered during the diagnosis and treatment of an uncommon variant of prostate cancer-mixed adenosquamous cell carcinoma of the prostate. Prostate cancers of this nature pose distinctive diagnostic and therapeutic dilemmas due to their rarity and complex histological composition. We present a case of a 63-year-old man with metastatic prostate cancer, featuring adenocarcinoma with squamous cell differentiation, who underwent a multimodal treatment approach. The patient responded to first-line carboplatin, docetaxel, and androgen deprivation therapy, followed by androgen receptor pathway inhibitor (ARPI) maintenance. However, disease progression led to radiation therapy and a subsequent switch to Lutetium (177Lu) vipivotide tetraxetan after chemotherapy challenges. Comprehensive genetic profiling revealed shared mutations in the prostate and liver lesions, emphasizing the role of targeted therapies. Prostate-specific membrane antigen (PSMA)-targeted therapy resulted in a notable PSA decline. This case highlights the evolving treatment landscape for rare prostate cancers, integrating genetic insights for tailored interventions. In conclusion, squamous cell carcinoma (SCC) of the prostate is rare, emphasizing the imperative for enhanced comprehension in diagnosis and management. Our case suggests the potential efficacy of ARPI and PSMA-targeted therapies. Our findings advocate for a more nuanced approach to the management of this rare prostate cancer variant, leveraging genomic insights for personalized treatment strategies. This exploration serves as a foundation for further research and clinical considerations in addressing the challenges posed by mixed adenosquamous cell carcinoma of the prostate.
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Affiliation(s)
- Emmanuella Oyogoa
- Department of Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Maya Sonpatki
- Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA
| | - Brian T. Brinkerhoff
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nicole Andeen
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Haley Meyer
- Department of Internal Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Christopher Ryan
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Alexandra O. Sokolova
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Sciences University, Portland, OR 97239, USA
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Zhang C, Jia Y, Kong Q. Case report: Squamous cell carcinoma of the prostate-a clinicopathological and genomic sequencing-based investigation. Pathol Oncol Res 2023; 29:1611343. [PMID: 38089646 PMCID: PMC10713708 DOI: 10.3389/pore.2023.1611343] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023]
Abstract
Squamous differentiation of prostate cancer, which accounts for less than 1% of all cases, is typically associated with androgen deprivation treatment (ADT) or radiotherapy. This entity is aggressive and exhibits poor prognosis due to limited response to traditional treatment. However, the underlying molecular mechanisms and etiology are not fully understood. Previous findings suggest that squamous cell differentiation may potentially arise from prostate adenocarcinoma (AC), but further validation is required to confirm this hypothesis. This paper presents a case of advanced prostate cancer with a combined histologic pattern, including keratinizing SCC and AC. The study utilized whole-exome sequencing (WES) data to analyze both subtypes and identified a significant overlap in driver gene mutations between them. This suggests that the two components shared a common origin of clones. These findings emphasize the importance of personalized clinical management for prostate SCC, and specific molecular findings can help optimize treatment strategies.
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Affiliation(s)
- Caixin Zhang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, China
| | - Yong Jia
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
| | - Qingnuan Kong
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, China
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He X, Yang K, Chen G, Zheng J. Squamous cell carcinoma of the prostate with lower urinary tract symptoms: A case report. Urol Case Rep 2021; 39:101796. [PMID: 34401350 PMCID: PMC8355914 DOI: 10.1016/j.eucr.2021.101796] [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: 07/13/2021] [Accepted: 08/01/2021] [Indexed: 11/22/2022] Open
Abstract
Primary squamous cell carcinoma of the prostate is a rare tumor. An 80-year-old man was admitted to hospital for half a year because of progressive dysuria and pain. Laboratory examination: TPSA 7.24ng/ml; FPSA 1.610ng/ml,%FreePSA 14.3%. Urine routine was normal. He was treated with thulium laser surgery of the prostate. The pathological result was poorly differentiated squamous cell carcinoma of the prostate. This report is helpful to the clinical manifestation and treatment of the disease.
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Affiliation(s)
- Xiang He
- Department of Urology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital), China
| | - Ke Yang
- Department of Urology, Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University), China
| | - Guiheng Chen
- Department of Urology, Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University), China
| | - Jue Zheng
- Department of Urology, Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University), China
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Hutten RJ, Weil CR, Tward JD, Lloyd S, Johnson SB. Patterns of Care and Treatment Outcomes in Locoregional Squamous Cell Carcinoma of the Prostate. EUR UROL SUPPL 2021; 23:30-33. [PMID: 34337486 PMCID: PMC8317810 DOI: 10.1016/j.euros.2020.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/28/2022] Open
Abstract
Primary squamous cell carcinoma is a rare, aggressive disease with historically poor outcomes and no established treatment guidelines. Case reports are limited but describe multiple treatment approaches. Seeking to identify practice patterns and treatment outcomes, we used the US National Cancer Data Base to identify 66 males with locoregional primary squamous cell carcinoma of the prostate treated with surgery, chemotherapy, and/or radiotherapy between 2004 and 2015. Patients were stratified into treatment groups consisting of local therapy alone (n = 40; 61%), local therapy and chemotherapy (n = 13; 20%), chemotherapy alone (n = 7; 11%), and observation (n = 6; 9%). Patients with clinical stage T3–T4 disease were significantly more likely to receive combined chemotherapy and local therapy on multivariable analysis. Median survival was 20 mo for patients treated with local therapy alone, 37 mo with local therapy and chemotherapy, and 11 mo with chemotherapy alone. Overall survival was not significantly different between treatment groups. Despite limitations in sample size, these data suggest that addition of chemotherapy to local therapy is a reasonable treatment approach for select patients. Patient summary Squamous cell carcinoma of the prostate is an extremely rare disease. Our review of patterns of care using data from the National Cancer Data Base shows inconsistent use of combined local and systemic therapy. The small sample size for this rare disease limits any conclusions regarding survival differences, but the data suggest that a combination approach using chemotherapy in addition to surgery or radiation is a reasonable treatment option for disease confined to the prostate.
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Affiliation(s)
- Ryan J Hutten
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Christopher R Weil
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Jonathan D Tward
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Shane Lloyd
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
| | - Skyler B Johnson
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah
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Hanna K, Lele SM, McCormick G, McMahon A, Hill B, Boyle SL. Primary prostatic squamous cell carcinoma. Urol Case Rep 2020; 34:101478. [PMID: 33235827 PMCID: PMC7670195 DOI: 10.1016/j.eucr.2020.101478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/21/2022] Open
Abstract
Primary prostate squamous cell malignancies are rare and very aggressive. A 65-year-old man presented to our institution with clinical and radiographic findings concerning for advanced prostatic malignancy. Surgical pathology of the tumor revealed poorly differentiated carcinoma with squamous differentiation, and histopathological markers were positive for markers of squamous differentiation negative for all urothelial and prostatic markers.
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Affiliation(s)
- Kevin Hanna
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
- Corresponding author
| | - Subodh M. Lele
- Department of Pathology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE 68198-3135, United States
| | - Grant McCormick
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Amber McMahon
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Brett Hill
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, 984110 Nebraska Medical Center, Omaha, NE 68198-4110, United States
| | - Shawna L. Boyle
- Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, 984110 Nebraska Medical Center, Omaha, NE 68198-4110, United States
- Corresponding author.
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Lau HD, Clark M. Metastatic squamous cell carcinoma transformed from prostatic adenocarcinoma following androgen deprivation therapy: A case report with clinicopathologic and molecular findings. Diagn Cytopathol 2020; 48:E14-E17. [PMID: 32628337 DOI: 10.1002/dc.24539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/16/2020] [Indexed: 12/21/2022]
Abstract
Squamous cell carcinoma (SCC) of the prostate is a rare and clinically aggressive entity that may arise de novo or through transformation of prostatic adenocarcinoma, typically following hormonal or radiation therapy. Confirmation of prostatic origin, especially when evaluating a metastatic focus, often requires correlation with clinical and imaging findings, as the morphologic and immunohistochemical features of SCC are not organ-specific. Comprehensive genomic profiling (CGP) may provide additional information useful for confirming the primary site and for identifying potential targeted therapy options. CGP data may also contribute to our understanding of the molecular basis of squamous differentiation in prostatic malignancies. However, these data are limited, and to our knowledge, there are only three previously published cases of prostatic SCC with reported CGP findings. Herein, we report a case of metastatic keratinizing SCC diagnosed by core needle biopsy in a 68-year-old man with a history of prostatic adenocarcinoma status post radical prostatectomy and androgen deprivation therapy (ADT). NKX3.1 immunohistochemistry was negative. CGP was performed, and a TMPRSS2-ERG fusion, among other genetic alterations, was detected, supporting a diagnosis of metastatic SCC transformed from prostatic adenocarcinoma following ADT. This case supports the use of CGP or other molecular techniques not only to query potential targeted therapy options but also to refine the diagnosis and confirm the primary site of disease in cases with non-specific morphologic and immunophenotypic features, such as SCC.
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Affiliation(s)
- Hubert D Lau
- VA Palo Alto Health Care System, Pathology and Laboratory Service, Palo Alto, California, USA
| | - Melissa Clark
- VA Palo Alto Health Care System, Pathology and Laboratory Service, Palo Alto, California, USA
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Dizman N, Salgia M, Ali SM, Wu H, Arvanitis L, Chung JH, Pal SK. Squamous Transformation of Prostate Adenocarcinoma: A Report of Two Cases With Genomic Profiling. Clin Genitourin Cancer 2019; 18:e289-e292. [PMID: 31882336 DOI: 10.1016/j.clgc.2019.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nazli Dizman
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Meghan Salgia
- Miller School of Medicine, University of Miami, Miami, FL
| | | | - Huiqing Wu
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Leonidas Arvanitis
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
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Lee J. Transformation of adenocarcinoma of prostate to squamous cell carcinoma following hormonal treatment: A case report and review of the literature. Radiol Case Rep 2019; 14:483-489. [PMID: 30805072 PMCID: PMC6374616 DOI: 10.1016/j.radcr.2019.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/26/2019] [Indexed: 10/28/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the prostate is a rare tumor with aggressive nature. This type of tumor has a poor response to conventional treatment and results in poor prognosis. Squamous differentiation or metaplasia may arise subsequent to endocrine or radiation treatment, but it is very rare. To date, a few cases have been reported in the literature. Due to its rarity, the radiologic findings of SCC of the prostate are not well established. We describe a case of SCC of the prostate developing in a patient with adenocarcinoma of the prostate following hormonal therapy. Furthermore, we review the imaging features of this rare disease across multiple imaging modalities.
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Affiliation(s)
- Jihyun Lee
- Department of Radiology, Donnam Institute of Radiological and Medical Science, 40, Jwadong-gil, Jangan-eup, Gijang-gun, Busan 46033, Republic of Korea
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