Skip to main content
SpringerLink
Log in

Mucinous, Signet Ring, Ductal, and Sarcomatoid Variants of Prostate Cancer

  • Chapter
  • First Online:
Rare Genitourinary Tumors

  • 546 Accesses

Abstract

Prostate cancer is one of the most common malignancies in men. The most common type of prostate cancer is prostate adenocarcinoma, which is well studied, both pathologically and clinically. Thus, the diagnosis and treatment of prostate adenocarcinoma is well characterized. However, there are morphologic subtypes of prostate adenocarcinoma and other carcinomas which are rarely observed in prostate, either alone or in combination with conventional adenocarcinoma. Gleason grading and the clinical course of these subtypes are less well understood, and guidelines for treatment do not exist. A knowledge of appropriate pathological diagnosis and appropriate treatment is important for improving outcomes of these patients. This chapter describes the epidemiology, pathology, clinical features of the mucinous, signet ring, ductal, and sarcomatoid variants of prostate cancer, and suggest optimal treatment options based on the data available in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.

    Article  PubMed  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA: Cancer J Clin. 2015;65:5–29.

    Google Scholar 

  3. Mohler JL, Kantoff PW, Armstrong AJ, et al. National comprehensive cancer network. J Natl Compr Canc Netw. 2014;12(5):686–718. PMID: 24812137.

    Google Scholar 

  4. Xie LP, Qin J, Zheng XY, et al. Age and pathological features of 481 prostate cancer patients. Zhonghua Nan Ke Xue. 2005;11:428–30.

    PubMed  Google Scholar 

  5. Epstein JI, Lieberman PH. Mucinous adenocarcinoma of the prostate gland. Am J Surg Pathol. 1985;9:299–308.

    Article  CAS  PubMed  Google Scholar 

  6. Grignon DJ. Unusual subtypes of prostate cancer. Mod Pathol. 2004;17:316–27.

    Article  PubMed  Google Scholar 

  7. Bohman KD, Osunkoya AO. Mucin-producing tumors and tumor-like lesions involving the prostate: a comprehensive review. Adv Anat Pathol. 2012;19:374–87.

    Article  CAS  PubMed  Google Scholar 

  8. Boyd S. A case of colloid scirrhus of the prostate. Trans Pathol Soc Lond. 1882;33:200–3.

    Google Scholar 

  9. Osunkoya AO, Nielsen ME, Epstein JI. Prognosis of mucinous adenocarcinoma of the prostate treated by radical prostatectomy: a study of 47 cases. Am J Surg Pathol. 2008;32:468–72.

    Article  PubMed  Google Scholar 

  10. Elbadawi A, Craig W, Linke CA, Cooper Jr RA. Prostatic mucinous carcinoma. Urology. 1979;13:658–66.

    Article  CAS  PubMed  Google Scholar 

  11. Watarai Y, Demura T, Togashi M, et al. Mucinous adenocarcinoma of the prostate. A case report and analysis of the literature. Nihon Hinyokika Gakkai Zasshi. 1994;85:1276–9.

    CAS  PubMed  Google Scholar 

  12. Kalaitzis C, Koukourakis M, Giannakopoulos S, et al. Metastatic mucinous adenocarcinoma of the prostate with PSA value of 8.6 ng/mL at 5-year-followup after prostatectomy, radiotherapy, and androgen deprivation. Case Rep Urol. 2014;2014:218628.

    PubMed  PubMed Central  Google Scholar 

  13. Ro JY, Grignon DJ, Ayala AG, Fernandez PL, Ordonez NG, Wishnow KI. Mucinous adenocarcinoma of the prostate: histochemical and immunohistochemical studies. Hum Pathol. 1990;21:593–600.

    Article  CAS  PubMed  Google Scholar 

  14. Epstein JI, Allsbrook Jr WC, Amin MB, Egevad LL, Committee IG. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29:1228–42.

    Article  PubMed  Google Scholar 

  15. Saito S, Iwaki H. Mucin-producing carcinoma of the prostate: review of 88 cases. Urology. 1999;54:141–4.

    Article  CAS  PubMed  Google Scholar 

  16. Johnson H, Zhou M, Osunkoya AO. ERG expression in mucinous prostatic adenocarcinoma and prostatic adenocarcinoma with mucinous features: comparison with conventional prostatic adenocarcinoma. Hum Pathol. 2013;44:2241–6.

    Article  CAS  PubMed  Google Scholar 

  17. Osunkoya AO, Adsay NV, Cohen C, Epstein JI, Smith SL. MUC2 expression in primary mucinous and nonmucinous adenocarcinoma of the prostate: an analysis of 50 cases on radical prostatectomy. Mod Pathol. 2008;21:789–94.

    Article  CAS  PubMed  Google Scholar 

  18. Ro JY, Ayala AG, Wishnow KI, Ordonez NG. Prostatic duct adenocarcinoma with endometrioid features: immunohistochemical and electron microscopic study. Semin Diagn Pathol. 1988;5:301–11.

    CAS  PubMed  Google Scholar 

  19. Saez C, Japon MA, Conde AF, Poveda MA, Luna-More S, Segura DI. Sialomucins are characteristically O-acylated in poorly differentiated and colloid prostatic adenocarcinomas. Mod Pathol. 1998;11:1193–7.

    CAS  PubMed  Google Scholar 

  20. Manne RK, Haddad FS. Mucinous adenocarcinoma of prostate. Urology. 1989;33:247–9.

    Article  CAS  PubMed  Google Scholar 

  21. Schiebler ML, Schnall MD, Outwater E. MR imaging of mucinous adenocarcinoma of the prostate. J Comput Assist Tomogr. 1992;16:493–4.

    Article  CAS  PubMed  Google Scholar 

  22. Westphalen AC, Coakley FV, Kurhanewicz J, Reed G, Wang ZJ, Simko JP. Mucinous adenocarcinoma of the prostate: MRI and MR spectroscopy features. AJR Am J Roentgenol. 2009;193:W238–43.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Outwater E, Schiebler ML, Tomaszewski JE, Schnall MD, Kressel HY. Mucinous carcinomas involving the prostate: atypical findings at MR imaging. J Magn Reson Imaging. 1992;2:597–600.

    Article  CAS  PubMed  Google Scholar 

  24. Curtis MW, Evans AJ, Srigley JR. Mucin-producing urothelial-type adenocarcinoma of prostate: report of two cases of a rare and diagnostically challenging entity. Mod Pathol. 2005;18:585–90.

    Article  PubMed  Google Scholar 

  25. Giltman L. Signet ring adenocarcinoma of the prostate. J Urol. 1981;126:134–5.

    CAS  PubMed  Google Scholar 

  26. Randolph TL, Amin MB, Ro JY, Ayala AG. Histologic variants of adenocarcinoma and other carcinomas of prostate: pathologic criteria and clinical significance. Mod Pathol. 1997;10:612–29.

    CAS  PubMed  Google Scholar 

  27. Torbenson M, Dhir R, Nangia A, Becich MJ, Kapadia SB. Prostatic carcinoma with signet ring cells: a clinicopathologic and immunohistochemical analysis of 12 cases, with review of the literature. Mod Pathol. 1998;11:552–9.

    CAS  PubMed  Google Scholar 

  28. Ro JY, el-Naggar A, Ayala AG, Mody DR, Ordonez NG. Signet-ring-cell carcinoma of the prostate. Electron-microscopic and immunohistochemical studies of eight cases. Am J Surg Pathol. 1988;12:453–60.

    Article  CAS  PubMed  Google Scholar 

  29. Matsuoka Y, Arai G, Ishimaru H, Takagi K, Ito Y. Primary signet-ring cell carcinoma of the prostate. Can J Urol. 2007;14:3764–6.

    PubMed  Google Scholar 

  30. Remmele W, Weber A, Harding P. Primary signet-ring cell carcinoma of the prostate. Hum Pathol. 1988;19:478–80.

    Article  CAS  PubMed  Google Scholar 

  31. Skodras G, Wang J, Kragel PJ. Primary prostatic signet-ring cell carcinoma. Urology. 1993;42:338–42.

    Article  CAS  PubMed  Google Scholar 

  32. Kwon WA, Oh TH, Ahn SH, Lee JW, Park SC. Primary signet ring cell carcinoma of the prostate. Can Urol Assoc J. 2013;7:E768–71.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Yoshimura K, Fukui I, Ishikawa Y, Maeda H, Yamauchi T, Kawai T. Locally-confined signet-ring cell carcinoma of the prostate: a case report of a long-term survivor. Int J Urol. 1996;3:406–7.

    Article  CAS  PubMed  Google Scholar 

  34. Lilleby W, Axcrona K, Alfsen GC, Urnes T, Hole KH. Diagnosis and treatment of primary signet-ring cell carcinoma of the prostate. Acta Oncol. 2007;46:1195–7.

    Article  PubMed  Google Scholar 

  35. Kanematsu A, Hiura M. Primary signet ring cell adenocarcinoma of the prostate treated by radical prostatectomy after preoperative androgen deprivation. Int J Urol. 1997;4:522–3.

    Article  CAS  PubMed  Google Scholar 

  36. Fujita K, Sugao H, Gotoh T, Yokomizo S, Itoh Y. Primary signet ring cell carcinoma of the prostate: report and review of 42 cases. Int J Urol. 2004;11:178–81.

    Article  PubMed  Google Scholar 

  37. Alguacil-Garcia A. Artifactual changes mimicking signet ring cell carcinoma in transurethral prostatectomy specimens. Am J Surg Pathol. 1986;10:795–800.

    Article  CAS  PubMed  Google Scholar 

  38. Celik O, Budak S, Ekin G, Akarken I, Ilbey YO. A case with primary signet ring cell adenocarcinoma of the prostate and review of the literature. Arch Ital Urol Androl. 2014;86:148–9.

    Article  PubMed  Google Scholar 

  39. Gravis G, Fizazi K, Joly F, et al. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol. 2013;14:149–58.

    Article  CAS  PubMed  Google Scholar 

  40. Melicow MM, Pachter MR. Endometrial carcinoma of proxtatic utricle (uterus masculinus). Cancer. 1967;20:1715–22.

    Article  CAS  PubMed  Google Scholar 

  41. Merchant Jr RF, Graham AR, Bucher Jr WC, Parker DA. Endometrial carcinoma of prostatic utricle with osseous metastases. Urology. 1976;8:169–73.

    Article  PubMed  Google Scholar 

  42. Oxley JD, Abbott CD, Gillatt DA, MacIver AG. Ductal carcinomas of the prostate: a clinicopathological and immunohistochemical study. Br J Urol. 1998;81:109–15.

    Article  CAS  PubMed  Google Scholar 

  43. Dube VE, Farrow GM, Greene LF. Prostatic adenocarcinoma of ductal origin. Cancer. 1973;32:402–9.

    Article  CAS  PubMed  Google Scholar 

  44. Epstein JI, Woodruff JM. Adenocarcinoma of the prostate with endometrioid features. A light microscopic and immunohistochemical study of ten cases. Cancer. 1986;57:111–9.

    Article  CAS  PubMed  Google Scholar 

  45. Dawkins HJ, Sellner LN, Turbett GR, et al. Distinction between intraductal carcinoma of the prostate (IDC-P), high-grade dysplasia (PIN), and invasive prostatic adenocarcinoma, using molecular markers of cancer progression. Prostate. 2000;44:265–70.

    Article  CAS  PubMed  Google Scholar 

  46. Brinker DA, Potter SR, Epstein JI. Ductal adenocarcinoma of the prostate diagnosed on needle biopsy: correlation with clinical and radical prostatectomy findings and progression. Am J Surg Pathol. 1999;23:1471–9.

    Article  CAS  PubMed  Google Scholar 

  47. Young BW, Lagios MD. Endometrial (papillary) carcinoma of the prostatic utricle – response to orchiectomy. A case report. Cancer. 1973;32:1293–300.

    Article  CAS  PubMed  Google Scholar 

  48. Kim A, Kwon T, You D, et al. Clinicopathological features of prostate ductal carcinoma: matching analysis and comparison with prostate acinar carcinoma. J Korean Med Sci. 2015;30:385–9.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Locke JR, Soloway MS, Evans J, Murphy WM. Osteogenic differentiation associated with x-ray therapy for adenocarcinoma of the prostate gland. Am J Clin Pathol. 1986;85:375–8.

    Article  CAS  PubMed  Google Scholar 

  50. Meeter UL, Richards JN. Osteogenic sarcoma of the prostate. J Urol. 1960;84:654–7.

    CAS  PubMed  Google Scholar 

  51. Shannon RL, Ro JY, Grignon DJ, et al. Sarcomatoid carcinoma of the prostate. A clinicopathologic study of 12 patients. Cancer. 1992;69:2676–82.

    Article  CAS  PubMed  Google Scholar 

  52. Fyfe G, Fisher RI, Rosenberg SA, Sznol M, Parkinson DR, Louie AC. Results of treatment of 255 patients with metastatic renal cell carcinoma who received high-dose recombinant interleukin-2 therapy. J Clin Oncol. 1995;13:688–96.

    CAS  PubMed  Google Scholar 

  53. Dundore PA, Cheville JC, Nascimento AG, Farrow GM, Bostwick DG. Carcinosarcoma of the prostate. Report of 21 cases. Cancer. 1995;76:1035–42.

    Article  CAS  PubMed  Google Scholar 

  54. Hansel DE, Epstein JI. Sarcomatoid carcinoma of the prostate: a study of 42 cases. Am J Surg Pathol. 2006;30:1316–21.

    Article  PubMed  Google Scholar 

  55. Rodrigues DN, Hazell S, Miranda S, et al. Sarcomatoid carcinoma of the prostate: ERG fluorescence in-situ hybridization confirms epithelial origin. Histopathology. 2015;66:898–901.

    Article  PubMed  Google Scholar 

  56. Lauwers GY, Schevchuk M, Armenakas N, Reuter VE. Carcinosarcoma of the prostate. Am J Surg Pathol. 1993;17:342–9.

    Article  CAS  PubMed  Google Scholar 

  57. Robinson D, Van Allen EM, Wu YM, et al. Integrative clinical genomics of advanced prostate cancer. Cell. 2015;161:1215–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology and Medical Oncology, University of Arizona Cancer Center, Banner University Medical Center, Tucson, AZ, USA

    Parminder Singh MD

  2. Department of Pathology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Dan Albertson MD

  3. Department of Medical Oncology and Experimental Therapeutics, City of Hope, Comprehensive Cancer Center, Duarte, CA, USA

    Sumanta K. Pal MD

  4. Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Ste 2123, Salt Lake City, UT, 84112, USA

    Neeraj Agarwal MD

Authors
  1. Parminder Singh MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dan Albertson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sumanta K. Pal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Neeraj Agarwal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Neeraj Agarwal MD .

Editor information

Editors and Affiliations

  1. Department of Oncology, Mayo Clinic, Division of Medical Oncology, Rochester, Minnesota, USA

    Lance Pagliaro

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Singh, P., Albertson, D., Pal, S.K., Agarwal, N. (2016). Mucinous, Signet Ring, Ductal, and Sarcomatoid Variants of Prostate Cancer. In: Pagliaro, L. (eds) Rare Genitourinary Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-30046-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-30046-7_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30044-3

  • Online ISBN: 978-3-319-30046-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation