Date of Presentation:11/16/2021

Attending pathologist: Anil Parwani, MD, PhD, MBA

Presented by: Saba Shafi, MD

Prepared by: Saba Shafi, MD

Organ:Prostate

HISTORY:

A 73-year-old male with a history of with uncontrolled back pain and spinal cord compression at T10-11; pathologic fracture at L4. He was recommended to undergo a course of radiation therapy to T9-L4. He completed 30 Gy in 10 fractions. A prostate biopsy was performed, even though serum PSA level was not elevated.

GROSS:

Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue

What is the most likely diagnosis?

  1. Prostatic adenocarcinoma, Gleason score 5+4=9
  2. Prostatic intraepithelial neoplasm (PIN), high grade with chronic inflammation
  3. Large cell neuroendocrine carcinoma (LCNEC)
  4. Prostatic adenocarcinoma with small cell/neuroendocrine features, Gleason score 5+5=10
Prostatic adenocarcinoma with small cell/neuroendocrine features, Gleason score 5+5=10

CASE SUMMARY