CT - Two weeks later
What is the prognosis of small cell neuroendocrine cancers of the prostate relative to prostate adenocarcinoma?
Poor. These are highly aggressive tumours - as seen with marked progression of disease in just two weeks.
List some paraneoplastic syndromes associated with this diagnosis.
Cushing's syndrome. SIADH. Limbic encephalitis.
List some neuroendocrine markers that the pathologist would have used in immunohistochemistry.
Synaptophysin, neurone-specific enolase, chromogranin and CD56.
What are some other neuroendocrine tumours of the prostate?
Adenocarcinoma with neuroendocrine differentiation. Well-differentiated neuroendocrine tumour. Large cell carcinoma.
Marked interval progression of disease. The patient now has ongoing bilateral leg pain but no other neurology. No spinal metastatic disease or canal compromise; however, the mass and its nodal metastases are invading the anterior surface of the psoas muscles bilaterally and may be involving nerves arising from the lumbar plexus.