Unusual prostate carcinoma characterized by extensive metastasis, significantly increased serum level of prostatic-specific antigen, and neuroendocrine differentiation: a case report

Some rare variants of prostate carcinoma have been described in recent years.1-3 In this article we report a man with uncommon prostate carcinoma with the following three pathological characteristics: （a） extensive metastasis to bone and lymph nodes of the abdomen, pelvis, and supraclavicular area; （b） significantly increased serum level of prostatic-specific antigen （PSA） as high as 1800 ng/ml; and （c） partial neuroendocrine differentiation in cancer tissue. The patient died 7 months after pathological diagnosis or 22 months after appearance of initial signs. This case has drawn our attention to the fact that pathological diversity of prostate neoplasm might easily lead to misdiagnosis or to delayed diagnosis, and moreover, reasonable therapy for such a case should be based on a thorough investigation. On the other hand, early initiation of appropriate treatment of advanced neuroendocrine carcinoma may improve the prognosis.