Demianets Roksolana, Ren Dong, Houshyar Roozbeh, Giannico Giovanna A, Johnson Cary
Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92868, USA.
Department of Radiological Sciences, University of California, Irvine, CA 92868, USA.
Diagnostics (Basel). 2024 Mar 19;14(6):645. doi: 10.3390/diagnostics14060645.
Prostate cancer accounts for 29% of malignant diagnoses among men in the United States and is the second leading cause of death from cancer. Effective screening methods and improved treatment have decreased the mortality rate significantly. This decreased mortality rate, however, does not apply to all histologic variants. Adenosquamous carcinoma of the prostate is an extremely aggressive neoplasm with no current known curative therapy. It is often diagnosed after chemotherapy, radiation, or androgen deprivation therapy for traditional prostatic adenocarcinomas. Primary carcinomas of the prostate with squamous features include, but are not limited to, pure squamous cell carcinoma and adenocarcinoma mixed with squamous cell carcinoma (SCC). Important distinguishable clinical features of adenosquamous carcinoma include normal prostate-specific antigen (PSA) levels, even with advanced disease and osteolytic versus osteoblastic metastatic lesions in adenocarcinoma. Additional entities to consider in the differential diagnosis are squamous metaplasia of the prostate, secondary involvement of pure SCC, and urothelial carcinoma with squamous differentiation. Here, we present a de novo case of adenosquamous carcinoma in a 48-year-old man who rapidly developed extensive metastatic disease.
前列腺癌占美国男性恶性肿瘤诊断病例的29%，是癌症死亡的第二大主要原因。有效的筛查方法和改进的治疗方法显著降低了死亡率。然而，这种死亡率的降低并不适用于所有组织学变体。前列腺腺鳞癌是一种极具侵袭性的肿瘤，目前尚无已知的治愈性疗法。它通常在对传统前列腺腺癌进行化疗、放疗或雄激素剥夺治疗后被诊断出来。具有鳞状特征的原发性前列腺癌包括但不限于纯鳞状细胞癌和与鳞状细胞癌（SCC）混合的腺癌。腺鳞癌重要的可区分临床特征包括前列腺特异性抗原（PSA）水平正常，即使在疾病晚期，以及腺癌中的溶骨性与成骨性转移病变。在鉴别诊断中需要考虑的其他实体包括前列腺鳞状化生、纯SCC的继发性累及以及具有鳞状分化的尿路上皮癌。在此，我们报告一例48岁男性的新发腺鳞癌病例，该患者迅速发展为广泛的转移性疾病。
