Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA.
Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA; Weill Medical College of Cornell University (WCMC), New York, NY 10065, USA.
Ann Diagn Pathol. 2021 Jun;52:151719. doi: 10.1016/j.anndiagpath.2021.151719. Epub 2021 Feb 17.
Pleomorphic giant cell carcinoma (PGCC) of the prostate is a rare entity categorized as a variant of prostatic acinar adenocarcinoma in the 2016 World Health Organization (WHO) classification system. PGCC differs from conventional prostatic adenocarcinoma by having bizarre, markedly enlarged, and pleomorphic cells. It differs from high grade urothelial carcinoma by negativity for urothelial differentiation markers, and can be distinguished from sarcomatoid carcinoma by lack of spindle cells. Including two new cases described herein, there have been 51 cases of prostate PGCC reported in the English literature. Clinical features shared by cases of prostate PGCC include poor prognosis, occurrence in older patients, and frequent association with prior therapy. Pathologic features common to cases of prostate PGCC include admixture with a high-grade conventional prostate carcinoma component and absent or reduced expression of prostate differentiation markers. More recent studies have begun to elucidate the molecular characteristics of PGCC, detecting specific mutations and chromosomal translocations, and showing evidence of a high degree of molecular instability in these tumors. We report novel findings in two cases of PGCC including a PIK3CA p.His1047Arg mutation not previously described. One of our cases is the first to clearly demonstrate chronological loss of prostate markers during dedifferentiation from prior conventional prostate carcinoma to PGCC. Herein, we present our two new cases and comprehensively review the literature on all reported cases of PGCC with critical commentary on findings in cases of this rare tumor.
前列腺多形性巨细胞癌（PGCC）是一种罕见的实体，在 2016 年世界卫生组织（WHO）分类系统中被归类为前列腺腺泡腺癌的变体。PGCC 与常规前列腺腺癌不同，具有奇异、明显增大和多形性的细胞。它与高级别尿路上皮癌的区别在于缺乏尿路上皮分化标志物的阴性，并且可以通过缺乏梭形细胞与肉瘤样癌区分开来。包括本文描述的两个新病例在内，英文文献中已有 51 例前列腺 PGCC 报道。前列腺 PGCC 的临床特征包括预后不良、发生在老年患者中以及频繁与既往治疗有关。前列腺 PGCC 的病理特征包括与高级别常规前列腺癌成分混合以及缺乏或减少前列腺分化标志物的表达。最近的研究开始阐明 PGCC 的分子特征，检测到特定的突变和染色体易位，并显示这些肿瘤具有高度的分子不稳定性的证据。我们报告了两例 PGCC 的新发现，包括以前未描述的 PIK3CA p.His1047Arg 突变。我们的一个病例是第一个明确证明在从先前的常规前列腺癌向 PGCC 去分化过程中前列腺标志物的时间性丧失。在此，我们报告了我们的两个新病例，并全面回顾了所有报道的 PGCC 病例的文献，对这种罕见肿瘤的病例进行了批判性评论。
