Abstract
•Large-cell neuroendocrine carcinoma (LCNEC) of the prostate is a rare type of prostate cancer.•Long-term ADT for conventional adenocarcinomas can induce transdifferentiation to LCNEC of the prostate.•LCNEC can arise de novo by direct malignant transformation of NE cells of the prostate with no prior history of ADT.•The pattern of metastasis of LCNEC resembles the pattern seen in conventional prostatic adenocarcinoma.•The late diagnosis, the age of the patient, and the co-morbidities had worsened the prognosis of LCNEC of the prostate.
Large-cell neuroendocrine carcinoma (LCNEC) of the prostate is a rare type of prostate cancer. Only eighteen case reports have been published in the literature to date. The present case report is the first case in the literature to describe brain metastasis of LCNEC of the prostate with neuroimaging, gross, and microscopic evaluation with immunohistochemistry
A 79-year old male with a history of high-grade prostatic adenocarcinoma treated with androgen deprivation therapy (ADT) who presented after remission with a severe headache and limbs weakness. Neuroimaging showed large right frontal lesion that caused a mass effect. Tumor resection was done, and the biopsy showed LCNEC of prostatic origin. The patient survived for 40 days after the diagnosis and tumor removal.
We discuss the spectrum of neuroendocrine differentiation in prostate carcinomas and the possible pathological pathways leading to the development of LCNEC of the prostate, and how it affects the presentation and the pattern of metastasis.
This case report describes a brain metastasis of a rare aggressive type of prostate cancer with poor prognosis. With metastatic lesions of prostatic adenocarcinoma, the probability of NE transdifferentiation increases. LCNEC has a poor prognosis attributed to its nature and late diagnosis. Thus, reporting and investigating such tumor will positively contribute to better management for future patients