Pleomorphic giant cell carcinoma of the prostate: clinicopathologic analysis and oncological outcomes.

Autor: Bilé-Silva A; Urology Department, Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal., Lopez-Beltran A; Pathology Department, Champalimaud Clinical Centre, Lisbon, Portugal. em1lobea@uco.es.; Department of Morphological Sciences, Cordoba University Medical School, Cordoba, Spain. em1lobea@uco.es., Rasteiro H; Pathology Department, Champalimaud Clinical Centre, Lisbon, Portugal., Vau N; Medical Oncology, Champalimaud Clinical Centre, Lisbon, Portugal., Blanca A; Department of Urology, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), Cordoba, 14004, Spain., Gomez E; Department of Urology, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), Cordoba, 14004, Spain., Gaspar F; Urology Department, Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal., Cheng L; Department of Pathology and Laboratory Medicine, Brown University Medical School, Lifespan Academic Medical Center, Providence, RI, 02903, USA.
Jazyk: angličtina
Zdroj: Virchows Archiv : an international journal of pathology [Virchows Arch] 2023 Mar; Vol. 482 (3), pp. 493-505. Date of Electronic Publication: 2023 Jan 05.
DOI: 10.1007/s00428-022-03481-7
Abstrakt: We report on the clinicopathologic features of 27 pleomorphic giant cell carcinoma (PGCC) cases of the prostate identified in 20 patients with an age range of 51 to 84 years (68 ± 9; median 71 years). Charlson comorbidity index ranged from 3 to 12. Serum PSA ranged from 4.30 to 662 ng/mL (median 13 ng/mL). On histologic examination, bizarre giant cells with pleomorphic nuclei characterized pleomorphic giant cell carcinoma of the prostate. PGCC component was present in 5% to 100%, with half of the patients presenting with ≥ 20%. Half of the patients initially presented with T4 and 26% with T3 disease. All patients were considered Gleason scores of 9 to 10 (ISUP grade 5). A combination of hormone therapy with chemotherapy with or without radiation therapy was applied in 68% of patients. On follow-up, 14 patients (52%) were alive with disease (1-69 months) or dead of disease (1-38 months). Patients diagnosed earlier with lower TNM stage had longer survival than those diagnosed at a later T-stage or with metastatic disease (p = 0.02). The percentage of PGCC was not related to survival in the current study. Molecular alterations in 3 samples showed a microsatellite-stable disease with low tumor mutation burden and variable PTEN, PTCH1, KDM6A, ARv7, and PIK3CA loss/alteration, TP53 mutation, TMPRSS2-ERG fusion, and MYC, PIK3CB, RICTOR, or IRS2 amplification. Our findings suggest that PGCC is a rare and aggressive subtype of prostate carcinoma whose recognition may steer clinicians to adopt more aggressive treatments and investigate new therapeutic strategies.
(© 2023. The Author(s).)
Databáze: MEDLINE
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