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- W2951880180 abstract "Objectives Neuroendocrine prostate cancer (NEPC) is a lethal prostate malignancy with a median survival of less than 1 year from time of detection. NEPC can occur de novo or more commonly as a treatment emergent phenomenon (t-NEPC). t-NEPC occurs in a subset of patients with metastatic-castration resistant prostate cancer. Two cases of t-NEPC with oral manifestations are presented highlighting the pathologic features and the varied clinical context in which these lesions presented. Patients and Methods Case 1) A 79 year-old man with a history of prostate adenocarcinoma undergoing hormone treatment presented with a fungating mass of the right maxilla and palate, clinically suspicious for squamous cell carcinoma. Biopsy revealed a high grade neuroendocrine carcinoma. Case 2) A 76 year-old man with a history of metastatic prostate adenocarcinoma receiving zoledronic acid and denosumab treatment for bony metastases, presented with mandibular fracture. A segmental resection without reconstruction with debridement was performed with a clinical diagnosis of medication-related osteonecrosis of the jaw (MRONJ). The pathology revealed a high grade neuroendocrine cell tumor. Both cases were positive for neuroendocrine markers chromogranin, synaptophysin, and CD56, and stained negative for prostate specific antigen (PSA) and prostate specific acid phosphatase (PSAP). Both tumors demonstrated a proliferative index (Ki-67) of 60-70%. An extended panel of immunostains appeared to eliminate other entities from consideration. Conclusions Awareness of t-NECP is of importance to correctly diagnosis the entity, recognizing that tumor markers such as PSA and PSAP are negative, and standard serum markers for prostate carcinoma may be stable or show no increase with progression of disease. Neuroendocrine carcinoma in the setting of medication related osteonecrosis of the jaw in a patient with prostate carcinoma needs to be included in the differential diagnosis." @default.
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- W2951880180 date "2019-07-01" @default.
- W2951880180 modified "2023-09-27" @default.
- W2951880180 title "METASTATIC NEUROENDOCRINE PROSTATE CANCER, AN AGGRESSIVE PROSTATE MALIGNANCY: A REPORT OF TWO CASES WITH ORAL MANIFESTATIONS" @default.
- W2951880180 doi "https://doi.org/10.1016/j.oooo.2019.02.099" @default.
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