Prostatic Small Cell Carcinoma: Diagnosis and Management


Prostatic small cell carcinoma (PSCC) is a distinct clinical phenotype of prostate cancer. Although rare, this phenotype is highly aggressive with very high mortality. Due to this, it is imperative for clinicians to be aware of it, diagnose it early and treat it appropriately. In this article we discuss the current literature, outline a plan for its diagnosis and management, and highlight latest research on this topic.

Share and Cite:

P. Singh, A. Algotar and E. Bracamonte, "Prostatic Small Cell Carcinoma: Diagnosis and Management," Journal of Cancer Therapy, Vol. 4 No. 3, 2013, pp. 804-810. doi: 10.4236/jct.2013.43097.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] D. M. Marcus, M. Goodman, A. B. Jani, A. O. Osunkoya and P. J. Rossi “A Comprehensive Review of Incidence and Survival in Patients with Rare Histological Variants of Prostate Cancer in the United States from 1973 to 2008,” Prostate Cancer Prostatic Diseases, Vol. 15, No. 3, 2012, pp. 283-288. doi:10.1038/pcan.2012.4
[2] W. Wang and J. I. Epstein, “Small Cell Carcinoma of the Prostate: A Morphologic and Immunohistochemical Study of 95 Cases,” American Journal of Surgical Pathology, Vol. 32, No. 1, 2008, pp. 65-71. doi:10.1097/PAS.0b013e318058a96b
[3] A. Aparicio, V. Tzelepi, J. C. Araujo, C. C. Guo, S. Liang, P. Troncoso, et al., “Neuroendocrine Prostate Cancer Xenografts with Large-Cell and Small-Cell Features Derived from a Single Patient’s Tumor: Morphological, Immunohistochemical, and Gene Expression Profiles,” The Prostate, Vol. 71, No. 8, 2011, pp. 846-856. doi:10.1002/pros.21301
[4] A. G. Aprikian, C. Cordon-Cardo, W. R. Fair, Z. F. Zhang, M. Bazinet, S. M. Hamdy, et al., “Neuroendocrine Differentiation in Metastatic Prostatic Adenocarcinoma,” The Journal of Urology, Vol. 151, No. 4, 1994, pp. 914-919.
[5] N. P. Caraway, C. V. Fanning, H. J. Shin and R. J. Amato, “Metastatic Small-Cell Carcinoma of the Prostate Diagnosed by Fine-Needle Aspiration Biopsy,” Diagnostic Cytopathology, Vol. 19, No. 1, 1998, pp. 12-16. doi:10.1002/(SICI)1097-0339(199807)19:1<12::AID-DC4>3.0.CO;2-Q
[6] J. L. Yao, R. Madeb, P. Bourne, J. Lei, X. Yang, S. Tickoo, et al., “Small Cell Carcinoma of the Prostate: An Immunohistochemical Study,” American Journal of Surgical Pathology, Vol. 30, No. 6, 2006, pp. 705-712. doi:10.1097/00000478-200606000-00005
[7] H. Chen, Y. Sun, C. Wu, C. E. Magyar, X. Li, L. Cheng, et al., “Pathogenesis of Prostatic Small Cell Carcinoma Involves the Inactivation of the P53 Pathway,” Endocrine-Related Cancer, Vol. 19, No. 3, 2012, pp. 321-331. doi:10.1530/ERC-11-0368
[8] T. Terada, “Small Cell Neuroendocrine Carcinoma of the Prostate: Incidence and a Report of Four Cases with an Examination of KIT and PDGFRA,” The Prostate, Vol. 72, No. 10, 2012, pp. 1150-1156. doi:10.1002/pros.22464
[9] N. Clegg, C. Ferguson, L. D. True, H. Arnold, A. Moorman, J. E. Quinn, et al., “Molecular Characterization of Prostatic Small-Cell Neuroendocrine Carcinoma,” The Prostate, Vol. 55, No. 1, 2003, pp. 55-64. doi:10.1002/pros.10217
[10] H. Beltran, D. S. Rickman, K. Park, S. S. Chae, A. Sboner, T. Y. MacDonald, et al., “Molecular Characterization of Neuroendocrine Prostate Cancer and Identification of New Drug Targets,” Cancer Discovery, Vol. 1, No. 6, 2011, pp. 487-495. doi:10.1158/2159-8290.CD-11-0130
[11] C. C. Guo, J. Y. Dancer, Y. Wang, A. Aparicio, N. M. Navone, P. Troncoso, et al., “TMPRSS2-ERG Gene Fusion in Small Cell Carcinoma of the Prostate,” Human Pathology, Vol. 42, No. 1, 2011, pp. 11-17. doi:10.1016/j.humpath.2010.05.026
[12] T. L. Lotan, N. S. Gupta, W. Wang, A. Toubaji, M. C. Haffner, A. Chaux, et al., “ERG Gene Rearrangements Are Common in Prostatic Small Cell Carcinomas,” Modern Pathology, Vol. 24, No. 6, 2011, pp. 820-828. doi:10.1038/modpathol.2011.7
[13] S. Culine, M. El Demery, P. J. Lamy, F. Iborra, C. Avances and F. Pinguet, “Docetaxel and Cisplatin in Patients with Metastatic Androgen Independent Prostate Cancer and Circulating Neuroendocrine Markers,” The Journal of Urology, Vol. 178, No. 3, 2007, pp. 844-848.
[14] C. N. Papandreou, D. D. Daliani, P. F. Thall, S. M. Tu, X. Wang, A. Reyes, et al., “Results of a Phase II Study with Doxorubicin, Etoposide, and Cisplatin in Patients with Fully Characterized Small-Cell Carcinoma of the Prostate,” Journal of Clinical Oncology, Vol. 20, No. 14, 2002, pp. 3072-3080. doi:10.1200/JCO.2002.12.065
[15] M. Z. Ahel, K. Kovacic, I. Kraljic and M. Tarle, “Oral Estramustine Therapy in Serum Chromogranin A-Positive Stage D3 Prostate Cancer Patients,” Anticancer Research, Vol. 21, No. 2B, 2001, pp. 1475-1479.
[16] D. B. Fried, D. E. Morris, C. Poole, J. G. Rosenman, J. S. Halle, F. C. Detterbeck, et al., “Systematic Review Evaluating the Timing of Thoracic Radiation Therapy in Combined Modality Therapy for Limited-Stage Small-Cell Lung Cancer,” Journal of Clinical Oncology, Vol. 22, No. 23, 2004, pp. 4837-4845. doi:10.1200/JCO.2004.01.178
[17] T. R. Asmis, M. N. Reaume, S. Dahrouge and S. Malone, “Genitourinary Small Cell Carcinoma: A Retrospective Review of Treatment and Survival Patterns at the Ottawa Hospital Regional Cancer Center,” BJU International, Vol. 97, No. 4, 2006, pp. 711-715. doi:10.1111/j.1464-410X.2006.06041.x
[18] J. H. Rubenstein, M. J. Katin, M. M. Mangano, J. Dauphin, S. A. Salenius, D. E. Dosoretz, et al., “Small Cell Anaplastic Carcinoma of the Prostate: Seven New Cases, Review of the Literature, and Discussion of a Therapeutic Strategy,” American Journal of Clinical Oncology, Vol. 20, No. 4, 1997, pp. 376-380. doi:10.1097/00000421-199708000-00011
[19] H. Aoki, S. Ishidoya, A. Ito, M. Endoh, T. Shimazui and Y. Arai, “Experience of the Treatment with Gemcitabine, Docetaxel, and Carboplatin (GDC) Chemotherapy for Patients with Small-Cell Carcinoma of the Prostate,” International Journal of Urology, Vol. 13, No. 9, 2006, pp. 1254-1258. doi:10.1111/j.1442-2042.2006.01514.x
[20] E. Mitry, E. Baudin, M. Ducreux, J. C. Sabourin, P. Rufie, T. Aparicio, et al., “Treatment of Poorly Differentiated Neuroendocrine Tumours with Etoposide and Cisplatin,” British Journal of Cancer, Vol. 81, No. 8, 1999, pp. 1351-1355. doi:10.1038/sj.bjc.6690325
[21] M. Z. Ahel, K. Kovacic, I. Kraljic and M. Tarle, “Oral Estramustine Therapy in Serum Chromogranin A-Positive Stage D3 Prostate Cancer Patients,” Anticancer Research, Vol. 21, No. 2B, 2001, pp. 1475-1479.
[22] D. N. Carney, P. J. Marangos, D. C. Ihde, P. A. Bunn Jr., M. H. Cohen, J. D. Minna, et al., “Serum Neuron-Specific Enolase: A Marker for Disease Extent and Response to Therapy of Small-Cell Lung Cancer,” The Lancet, Vol. 319, No. 8272, 1982, pp. 583-585. doi:10.1016/S0140-6736(82)91748-2
[23] K. Junker, T. Wiethege and K. M. Muller, “Pathology of Small-Cell Lung Cancer,” Journal of Cancer Research and Clinical Oncology, Vol. 126, No. 7, 2000, pp. 361-368. doi:10.1007/PL00008483
[24] National Comprehensive Cancer Network, “NCCN Clinical Practice Guidelines,” 2013. http://www.nccn. org/professi onals/physician_gls/ pdf/prostate.pdf
[25] S. Sundstrom, R. M. Bremnes, S. Kaasa, U. Aasebo, R. Hatlevoll, R. Dahle, et al., “Cisplatin and Etoposide Regimen is Superior to Cyclophosphamide, Epirubicin, and Vincristine Regimen in Small-Cell Lung Cancer: Results from a Randomized Phase III Trial with 5 Years’ Follow-Up,” Journal of Clinical Oncology, Vol. 20, No. 24, 2002, pp. 4665-4672. doi:10.1200/JCO.2002.12.111
[26] B. J. Roth, D. H. Johnson, L. H. Einhorn, L. P. Schacter, N. C. Cherng, H. J. Cohen, et al., “Randomized Study of Cyclophosphamide, Doxorubicin, and Vincristine versus Etoposide and Cisplatin versus Alternation of These Two Regimens in Extensive Small-Cell Lung Cancer: A Phase III Trial of the Southeastern Cancer Study Group,” Journal of Clinical Oncology, Vol. 10, No. 2, 1992, pp. 282-291.
[27] A. Rossi, M. Di Maio, P. Chiodini, R. M. Rudd, H. Okamoto, D. V. Skarlos, et al., “Carboplatinor CisplatinBased Chemotherapy in First-Line Treatment of SmallCell Lung Cancer: The COCIS Meta-Analysis of Individual Patient Data,” Journal of Clinical Oncology, Vol. 30, No. 14, 2012, pp. 1692-1698. doi:10.1200/JCO.2011.40.4905
[28] M. E. O’Brien, T. E. Ciuleanu, H. Tsekov, Y. Shparyk, B. Cucevia, G. Juhasz, et al., “Phase III Trial Comparing Supportive Care Alone with Supportive Care with Oral Topotecan in Patients with Relapsed Small-Cell Lung Cancer,” Journal of Clinical Oncology, Vol. 24, No. 34, 2006, pp. 5441-5447. doi:10.1200/JCO.2006.06.5821
[29] G. R. Simon and H. Wagner, “American College of Chest Physicians. Small Cell Lung Cancer,” Chest, Vol. 123, No. 1, 2003, pp. 259S-271S. doi:10.1378/chest.123.1_suppl.259S
[30] J. R. Mackey, H. J. Au, J. Hugh and P. Venner, “Genitourinary Small Cell Carcinoma: Determination of Clinical and Therapeutic Factors Associated with Survival,” The Journal of Urology, Vol. 159, No. 5, 1998, pp. 1624-1629. doi:10.1097/00005392-199805000-00058
[31] M. Bolla, H. van Poppel, B. Tombal, K. Vekemans, L. Da Pozzo, T. M. de Reijke, et al., “Postoperative Radiotherapy after Radical Prostatectomy for High-Risk Prostate Cancer: Long-Term Results of a Randomised Controlled Trial (EORTC Trial 22911),” The Lancet, Vol. 380, No. 9858, 2012, pp. 2018-2027. doi:10.1016/S0140-6736(12)61253-7
[32] K. Fizazi, M. Carducci, M. Smith, R. Damiao, J. Brown, L. Karsh, et al., “Denosumab versus Zoledronic Acid for Treatment of Bone Metastases in Men with CastrationResistant Prostate Cancer: A Randomised, Double-Blind Study,” The Lancet, Vol. 377, No. 9768, 2011, pp. 813-822. doi:10.1016/S0140-6736(10)62344-6
[33] H. J. Meulenbeld, J. P. Bleuse, E. M. Vinci, E. Raymond, G. Vitali, A. Santoro, et al., “Randomized Phase II Study of Danusertib in Patients with Metastatic Castration-Resistant Prostate Cancer after Docetaxel Failure,” BJU International, Vol. 111, No. 1, 2013, pp. 44-52.
[34] A. Berruti, A. Mosca, F. Porpiglia, E. Bollito, M. Tucci, F. Vana, et al., “Chromogranin A Expression in Patients with Hormone Naive Prostate Cancer Predicts the Development of Hormone Refractory Disease,” The Journal of Urology, Vol. 178, No. 3, 2007, pp. 838-843, 1129.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.