Difference between revisions of "Sarcomatoid carcinoma of the prostate"

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'''Sarcomatoid prostate carcinoma''' is a rare subtype of [[prostatic carcinoma]], that may be confused with a [[sarcoma]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =  Sarcomatoid_prostate_carcinoma_-_alt_--_intermed_mag.jpg
| Width      =
| Caption    = Sarcomatoid carcinoma of the prostate. [[H&E stain]].
| Synonyms  = sarcomatoid prostatic carcinoma
| Micro      =
| Subtypes  = (subtype of [[prostate carcinoma]])
| LMDDx      = [[sarcoma]], [[sarcomatoid urothelial carcinoma]]
| Stains    =
| IHC        = PSA +ve, keratin +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  = [[prostate biopsy]], [[prostate chips]], [[radical prostatectomy]]
| Staging    = [[prostate cancer staging]]
| Site      = [[prostate gland]] - see ''[[prostate carcinoma]]''
| Assdx      =
| Syndromes  = see ''[[prostate carcinoma]]''
| Clinicalhx = typically have history of conventional prostate carcinoma
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = see ''[[prostate carcinoma]]''
| Tx        = see ''[[prostate carcinoma]]''
}}
'''Sarcomatoid carcinoma of the prostate''', also '''sarcomatoid prostatic carcinoma''', is a rare subtype of [[prostatic carcinoma]] with histomorphologic features suggestive of a sarcoma, and a poor prognosis.


==General==
==General==
*Rare.
*Rare.<ref name=pmid17001164>{{Cite journal  | last1 = Hansel | first1 = DE. | last2 = Epstein | first2 = JI. | title = Sarcomatoid carcinoma of the prostate: a study of 42 cases. | journal = Am J Surg Pathol | volume = 30 | issue = 10 | pages = 1316-21 | month = Oct | year = 2006 | doi = 10.1097/01.pas.0000209838.92842.bf | PMID = 17001164 }}</ref>
*Poor prognosis - estimated 20% mortality at one year.<ref name=pmid17001164/>


==Microscopic==
==Microscopic==
Features:<ref name=Ref_GUP80>{{Ref GUP|77 & 80}}</ref>
Features:<ref name=Ref_GUP80>{{Ref GUP|77 & 80}}</ref>
*Biphasic tumour:
*Typically a biphasic tumour:
*#Spindle cells (sarcomatous component).
*#Spindle cells (sarcomatous component).
*#*May include components of: [[osteosarcoma]], [[chondrosarcoma]] and/or [[rhabdomyosarcoma]].
*#*May include components of: [[osteosarcoma]], [[chondrosarcoma]] and/or [[rhabdomyosarcoma]].
*#Glandular component (like conventional prostate carcinoma).
*#Epithelial (glandular) component (like conventional prostate carcinoma).
*#*May be absent. ‡
 
Note:
* ‡ The history is should be compelling or the tumour keratin positive, if no epithelial component is present. 
 
DDx:
*[[Sarcomatoid urothelial carcinoma]].
*[[Sarcoma]], e.g. [[rhabdomyosarcoma]], [[liposarcoma]], [[leiomyosarcoma]].
 
===Images===
Sarcomatoid carcinoma:
<gallery>
Image: Sarcomatoid prostate carcinoma -- low mag.jpg | SPC - low mag.
Image: Sarcomatoid prostate carcinoma -- intermed mag.jpg | SPC - intermed. mag.
Image: Sarcomatoid prostate carcinoma -- high mag.jpg | SPC - high mag.
Image: Sarcomatoid prostate carcinoma -- very high mag.jpg | SPC - very high mag.
Image: Sarcomatoid prostate carcinoma - alt -- intermed mag.jpg | SPC - intermed. mag.
Image: Sarcomatoid prostate carcinoma - alt -- high mag.jpg | SPC - high mag.
Image: Sarcomatoid prostate carcinoma - alt -- very high mag.jpg | SPC - very high mag.
</gallery>
Accompanying (conventional) prostatic carcinoma:
<gallery>
Image: Conventional prostate carcinoma -- intermed mag.jpg | SCP - intermed. mag.
Image: Conventional prostate carcinoma -- high mag.jpg | SCP - intermed. mag.
</gallery>


==IHC==
==IHC==

Latest revision as of 03:40, 9 February 2016

Sarcomatoid carcinoma of the prostate
Diagnosis in short

Sarcomatoid carcinoma of the prostate. H&E stain.
Synonyms sarcomatoid prostatic carcinoma
Subtypes (subtype of prostate carcinoma)
LM DDx sarcoma, sarcomatoid urothelial carcinoma
IHC PSA +ve, keratin +ve
Grossing notes prostate biopsy, prostate chips, radical prostatectomy
Staging prostate cancer staging
Site prostate gland - see prostate carcinoma
Syndromes see prostate carcinoma
Clinical history typically have history of conventional prostate carcinoma
Prevalence uncommon
Prognosis poor
Clin. DDx see prostate carcinoma
Treatment see prostate carcinoma

Sarcomatoid carcinoma of the prostate, also sarcomatoid prostatic carcinoma, is a rare subtype of prostatic carcinoma with histomorphologic features suggestive of a sarcoma, and a poor prognosis.

General

  • Rare.[1]
  • Poor prognosis - estimated 20% mortality at one year.[1]

Microscopic

Features:[2]

  • Typically a biphasic tumour:
    1. Spindle cells (sarcomatous component).
    2. Epithelial (glandular) component (like conventional prostate carcinoma).
      • May be absent. ‡

Note:

  • ‡ The history is should be compelling or the tumour keratin positive, if no epithelial component is present.

DDx:

Images

Sarcomatoid carcinoma:

  • SPC - low mag.

  • SPC - intermed. mag.

  • SPC - high mag.

  • SPC - very high mag.

  • SPC - intermed. mag.

  • SPC - high mag.

  • SPC - very high mag.

Accompanying (conventional) prostatic carcinoma:

  • SCP - intermed. mag.

  • SCP - intermed. mag.

IHC

Features - typical:[2]

  • PSA +ve.
  • Keratin +ve.

See also

References

  1. ↑ 1.0 1.1 Hansel, DE.; Epstein, JI. (Oct 2006). "Sarcomatoid carcinoma of the prostate: a study of 42 cases.". Am J Surg Pathol 30 (10): 1316-21. doi:10.1097/01.pas.0000209838.92842.bf. PMID 17001164.
  2. ↑ 2.0 2.1 Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 77 & 80. ISBN 978-0443066771.
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