Work

Prostatic adenocarcinoma with neuroendocrine differentiation presenting as paraplegia due to vertebral metastases: a case report

Year: 2025

Type: article

Abstract: Prostate cancer is a common malignancy, but cases with neuroendocrine differentiation are rare and often clinically aggressive. Objectives. To describe a rare case of de novo prostatic adenocarcinoma with neuroendocrine differentiation presenting as acute paraplegia from vertebral metastases. Case presentation. A 65-year-old man presented with progressive lower limb weakness, back pain, and urinary incontinence. Examination revealed paraplegia below T4. MRI showed a T2 vertebral compression fracture with spinal cord compression; PET-CT identified a prostatic lesion and widespread bone metastases. Biopsies revealed high-grade acinar adenocarcinoma (Gleason 4+5=9) in the right lobe and a neuroendocrine component (Gleason 5+5=10) in the left. Immunohistochemistry showed PSA and AR positivity in both components, with synaptophysin and chromogranin expression in the solid areas, and a Ki-67 index of ~30%. Outcome. The patient was diagnosed with de novo high-grade prostatic adenocarcinoma exhibiting neuroendocrine differentiation. His condition deteriorated despite supportive and palliative interventions, leading to death approximately three months post-diagnosis. Conclusions. Early recognition through histopathological and immunohistochemical analysis is essential for diagnosis and management. The patient died within three months of diagnosis, underscoring the aggressive nature and poor prognosis of this disease.

Source: Romanian Medical Journal

DOI: 10.37897/rmj.2025.4.2

Authors: Vinesia L. Riddi, Rahmat Budi Santoso, David Sitinjak, Ros Nirmawati

Institution: Dharmais Cancer Hospital

Language: English

Topic: Prostate Cancer Treatment and Research

Subfield: Cancer Research

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $192