Extensive Metastases in Prostatic Carcinoma with Normal Prostate-Specific Antigen and Raised Carcinoembryonic Antigen – Small Cell Carcinoma of Prostate: A Rare Entity

Sanjay Mhalasakant Khaladkar; Kunaal Mahesh Jain; Arijit Ghosh; Rajesh Kuber

doi:10.4103/ijmpo.ijmpo_72_17

Indian Journal of Medical and Paediatric Oncology, Table of Contents

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2018; 39(04): 539-542
DOI: 10.4103/ijmpo.ijmpo_72_17

Case Report

Extensive Metastases in Prostatic Carcinoma with Normal Prostate-Specific Antigen and Raised Carcinoembryonic Antigen – Small Cell Carcinoma of Prostate: A Rare Entity

Sanjay Mhalasakant Khaladkar

Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India

,

Kunaal Mahesh Jain

Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India

,

Arijit Ghosh

Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India

,

Rajesh Kuber

Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India

› Author Affiliations

Abstract

Small cell carcinoma of prostate is a neuroendocrine tumor of prostate seen in 0.5%–2% of men with carcinoma prostate. Prostate-specific antigen (PSA) is a common tumor marker which is often raised in prostatic carcinoma. However, prostatic carcinoma can progress with normal or low serum PSA levels at the time of diagnosis. Carcinoembryonic antigen (CEA) is a tumor marker of different carcinomas. Small cell carcinoma prostate is a highly aggressive tumor which can progress with normal or low serum PSA levels and raised CEA levels. We report a case of 65-year-old male with enlarged prostate with extra-prostatic spread, hepatic metastases, metastatic retroperitoneal and pelvic lymph nodes, osteoblastic metastasis in lumbar spine with normal serum PSA, and raised CEA levels. Prostatic biopsy was suggestive of small cell carcinoma.

Keywords

Carcinoembryonic antigen - neuroendocrine tumor - prostate-specific antigen - prostatic carcinoma - small cell carcinoma

Full Text

References

References
1 Mikuz G. Histologic classification of prostate cancer. Anal Quant Cytopathol Histpathol 2015; 37: 39-47
2 Brandes A, Weinmann M, Reichmann U, Becker G, Gärtner HV, Bamberg M. Serum elevation of CEA and CA 19-9 in an aggressive variant of prostatic carcinoma. Acta Oncol 2001; 40: 879-81
3 Leibovici D, Spiess PE, Agarwal PK, Tu SM, Pettaway CA, Hitzhusen K. et al. Prostate cancer progression in the presence of undetectable or low serum prostate-specific antigen level. Cancer 2007; 109: 198-204
4 Yamamoto S, Ito T, Akiyama A, Aizawa T, Miki M, Tachibana M. M1 prostate cancer with a serum level of prostate-specific antigen less than 10 ng/mL. Int J Urol 2001; 8: 374-9
5 Juang GD, Hwang TI, Wang YH. Metastatic prostate cancer with elevated serum levels of CEA and CA19-9. Urol Sci 2014; 25: 28-30
6 Ghazizadeh M, Kagawa S, Izumi K, Maebayashi K, Takigawa H, Saiki T. et al. Immunohistochemical detection of carcinoembryonic antigen in benign hyperplasia and adenocarcinoma of the prostate with monoclonal antibody. J Urol 1984; 131: 501-3
7 Feuer JA, Lush RM, Venzon D, Duray P, Tompkins A, Sartor O. et al. Elevated carcinoembryonic antigen in patients with androgen-independent prostate cancer. J Investig Med 1998; 46: 66-72
8 Nishio R, Furuya Y, Nagakawa O, Fuse H. Metastatic prostate cancer with normal level of serum prostate-specific antigen. Int Urol Nephrol 2003; 35: 189-92
9 Sella A, Konichezky M, Flex D, Sulkes A, Baniel J. Low PSA metastatic androgen- independent prostate cancer. Eur Urol 2000; 38: 250-4
10 Nadal R, Schweizer M, Kryvenko ON, Epstein JI, Eisenberger MA. Small cell carcinoma of the prostate. Nat Rev Urol 2014; 11: 213-9
11 Rubenstein JH, Katin MJ, Mangano MM, Dauphin J, Salenius SA, Dosoretz DE. et al. Small cell anaplastic carcinoma of the prostate: Seven new cases, review of the literature, and discussion of a therapeutic strategy. Am J Clin Oncol 1997; 20: 376-80