What are the other Names for this Condition? (Also known as/Synonyms)

• Prostatic Small Cell Neuroendocrine Carcinoma
• SCNEC of the Prostate Gland
• Small Cell Neuroendocrine Carcinoma of the Prostate Gland

What is Small Cell Neuroendocrine Carcinoma of the Prostate? (Definition/Background Information)

• Small Cell Neuroendocrine Carcinoma (SCNEC) of the Prostate is a rare high-grade neuroendocrine tumor that is seen in the prostate gland
• Neuroendocrine tumors (NETs) are tumors showing neuroendocrine differentiation
• The prostate is a gland that encircles the urethra in males. It secretes a fluid that forms a part of semen
• In the genitourinary system, the most common location of SCNEC is the prostate gland and urinary bladder

Incidence:

• Prostatic Small Cell Neuroendocrine Carcinomas are extremely rare; less than 0.03% of the prostatic malignancies are of this tumor type
• A vast majority of prostate cancer cases are noted in men over the age of 45 years
• All races and ethnic groups are at risk

Risk factors:

• Smoking
• Other risk factors have not been well-characterized

Cause:

• The cause of tumor formation is unknown
• Loss of RB1 and TP53 tumor suppressor genes is noted in many cases

Signs and symptoms:

• Hematuria (blood in urine)
• Frequent urination at night (nocturia)
• Pain when urinating
• Abnormal pain in the bones
• Hematospermia (blood in semen)
• Some individuals have paraneoplastic syndrome due to over-production of a variety of hormones resulting in associated signs and symptoms

Diagnosis:

• Blood and urine tests such as prostate specific antigen (PSA) test
• Radiological studies
  • Ultrasound of abdomen
  • CT and MRI scan of abdomen
• Tissue biopsy of the tumor is extremely critical to arrive at a definitive diagnosis
  • The diagnosis of prostate SCNEC may be challenging; an exclusion of conventional adenocarcinoma of the prostate gland is important prior to establishing a diagnosis, since both have similar clinical features
• Another important factor is the elevation of PSA in conventional adenocarcinoma of the prostate. Small Cell Neuroendocrine Carcinoma of Prostate do not cause elevation of PSA levels
• Presence of increased serum levels of chromogranin a, worsening urinary bladder symptoms, resistance to androgen deprivation therapy (usually administered for conventional adenocarcinoma of prostate) should raise a suspicion for SCNEC of Prostate

Complications:

• Emotional stress
• SCNEC is usually metastasized to visceral organs and lymph nodes at the time of diagnosis (whereas conventional adenocarcinoma of the prostate typically metastasizes to the bones)
• Incomplete removal resulting in tumor recurrence

Treatment:

• The staging protocols are still being established
• Currently, Union for International Cancer Control (UICC) eighth-edition staging system is used to classify such tumors
• Treatment depends on cancer stage and health of the individual
• It may require a combination of surgery, chemotherapy, and radiation therapy

Prevention: Presently, it is not possible to prevent the formation of Small Cell Neuroendocrine Carcinoma of the Prostate.

Prognosis:

• The prognosis depends on the stage of the tumor
• These tumors are usually high grade and have poor prognosis due to an aggressive growth pattern
• Studies have shown that Prostatic Neuroendocrine Small Cell Carcinomas have worse prognosis than SCNECs in the urinary bladder