Primary large-cell neuroendocrine carcinoma of the prostate

Introduction. Depending on neuroendocrine differentiation, the prostate cancer is divided into two major groups: primary neuroendocrine prostate tumour (carcinoid, small-cell, and large-cell neuroendocrine carcinoma) or as a focal tumour in conventional adenocarcinoma. Large-cell neuroendocrine carcinoma of the prostate is very rare. Case presentation. A 72-year-old man was diagnosed with a high-grade adenocarcinoma Gleason 9 (4 + 5) by needle biopsy and subsequently, after prostatectomy, with a large-cell neuroendocrine carcinoma without areas of prostatic adenocarcinoma. The patient was prescribed chemotherapy (etoposide and cisplatin) with subsequent radiation therapy by a Tumour Board. For the last 5 months, he is in partial remission. Conclusions. An extremely rare case of primary large-cell neuroendocrine carcinoma of the prostate has been reported. Prostate needle biopsy may omit neuroendocrine carcinomas. In low-grade prostate cancer, especially diagnosed by needle biopsy, the inclusion of neuroendocrine markers is recommended to exclude neuroendocrine tumours. A broad panel of immunohistochemistry markers, including E-26 transformation-specific related gene (ERG), can rule out metastatic neuroendocrine carcinomas of the prostate.