Sarcomatoid carcinoma of the prostate

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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.

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

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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