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Presented by Dr. Andres Matoso and prepared by Dr. Monica Butcher
Adult male with lower urinary tract symptoms, TURP
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1. Question
Adult male with lower urinary tract symptoms, TURP
Diagnosis:
Correct
Correct: B
Histology: Prostate tissue with large cribriform glands with central necrosis and a proliferation of spindle cells in myxoid background.
Discussion: Sarcomatoid carcinoma (“carcinosarcoma”) of the prostate is a rare type of prostate cancer that demonstrates a combination of malignant epithelial and sarcomatoid components. The epithelial component of these tumors is often a high-grade adenocarcinoma, although squamous and urothelial components have also been reported. The accompanying sarcomatoid component often demonstrates a spindled appearance, although heterologous elements resembling osteosarcoma, rhabdomyosarcoma, chondrosarcoma, and angiosarcoma may be present in a subset of cases. In general, sarcomatoid carcinoma of the prostate has been described as an aggressive neoplasm with an associated poor prognosis. Although the origin of these tumors has been controversial, the epithelial and sarcomatoid components are currently thought to be derived from a single cell of origin, rather than representing a combination of separate epithelial and mesenchymal tumor types colliding in the same organ. Sarcomatoid carcinoma of the prostate is a highly aggressive neoplasm that leads to a poor patient outcome in most, if not all, cases.
References
1. Am J Surg Pathol. 2006 Oct; 30(10):1316-21.Incorrect
Correct: B
Histology: Prostate tissue with large cribriform glands with central necrosis and a proliferation of spindle cells in myxoid background.
Discussion: Sarcomatoid carcinoma (“carcinosarcoma”) of the prostate is a rare type of prostate cancer that demonstrates a combination of malignant epithelial and sarcomatoid components. The epithelial component of these tumors is often a high-grade adenocarcinoma, although squamous and urothelial components have also been reported. The accompanying sarcomatoid component often demonstrates a spindled appearance, although heterologous elements resembling osteosarcoma, rhabdomyosarcoma, chondrosarcoma, and angiosarcoma may be present in a subset of cases. In general, sarcomatoid carcinoma of the prostate has been described as an aggressive neoplasm with an associated poor prognosis. Although the origin of these tumors has been controversial, the epithelial and sarcomatoid components are currently thought to be derived from a single cell of origin, rather than representing a combination of separate epithelial and mesenchymal tumor types colliding in the same organ. Sarcomatoid carcinoma of the prostate is a highly aggressive neoplasm that leads to a poor patient outcome in most, if not all, cases.
References
1. Am J Surg Pathol. 2006 Oct; 30(10):1316-21.
