Prostatic Adenosquamous Carcinoma With a Minute Squamous Component in the Initial Biopsy and Early Liver Metastasis: A Case Report

IF 0.5 Q4 Medicine

IJU Case Reports Pub Date : 2026-10-04 DOI:10.1002/iju5.70262

Yohei Tsubouchi, Taku Naiki, Aya Naiki-Ito, Rei Unno, Toshiki Etani, Takashi Nagai, Toshiharu Morikawa, Daiki Ishikawa, Hiroko Suzuki, Takahiro Yasui

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Abstract

Introduction

We report a case of de novo prostatic adenosquamous carcinoma with a minute squamous component in the initial biopsy and early liver metastasis despite a marked prostate-specific antigen response.

Case Presentation

A 72-year-old man was diagnosed with locally advanced prostate cancer with nodal and multiple bone metastases. Prostate biopsy initially showed adenocarcinoma with a Gleason score of 4 + 5. After leuprolide and abiraterone plus radiotherapy, prostate-specific antigen decreased from 13.0 to 0.22 ng/mL; however, a liver metastasis developed. Re-evaluation of the prostate biopsy revealed minute squamous differentiation, and liver biopsy showed metastatic squamous cell carcinoma. Immunohistochemistry showed retained MLH1 and PMS2 expression with loss of MSH2 and MSH6 in both specimens. Genomic profiling showed microsatellite instability-high status.

Conclusion

Repeat biopsy and molecular-pathological reassessment may be important when radiographic progression is discordant with prostate-specific antigen kinetics.

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前列腺腺鳞状癌早期活检有微小鳞状成分及早期肝转移一例报告。

我们报告一例新发前列腺腺鳞状癌，尽管有明显的前列腺特异性抗原反应，但在最初的活检和早期肝转移中有微小的鳞状成分。病例介绍：一名72岁男性被诊断为局部晚期前列腺癌伴淋巴结和多发性骨转移。前列腺活检最初显示腺癌，Gleason评分为4 + 5。leuprolide、abiraterone联合放疗后，前列腺特异性抗原由13.0降至0.22 ng/mL；然而，出现了肝转移。重新评估前列腺活检显示微小鳞状分化，肝脏活检显示转移性鳞状细胞癌。免疫组化结果显示，两种标本均保留了MLH1和PMS2的表达，而MSH2和MSH6的表达缺失。基因组图谱显示微卫星不稳定-高状态。结论：当放射学进展与前列腺特异性抗原动力学不一致时，重复活检和分子病理重新评估可能是重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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