Determination of Sarcomatoid Carcinoma of the Prostate with Bladder Invasion: About Two Case Reports

This chapter report two cases of prostate SC with bladder invasion not long after transurethral resection of the prostate (TURP) and androgen deprivation. In order to briefly summarise the biochemical, morphological, and imaging features of sarcomatoid cancer (SC) of the prostate with bladder invasion shortly after castration.

Our two cases were initially diagnosed with adenocarcinoma of the prostate due to dysuria. However, prostate SC was diagnosed after transurethral resection of the prostate (TURP) and castration after only 5 and 10 mo, respectively. Distinctive liver-like tissues appeared in the second TURP procedure in case 1, while a white, fish flesh-like, narrow pedicled soft globe protruded from the prostate to the bladder in case 2. Our study results suggest that SCs may originate from a special group of hormonal resistant prostate stromal cancer cells found near the bladder neck and they may accelerate their growth when exposed to stimulation and changes in their environment.

One of the unique cancer cell populations that are resistant to hormone therapy may be where the sarcomatoid component of SC develops. SCs' morphological traits can manifest as "fish flesh" and "red hepatization". SCs grow rapidly and have a poor prognosis, and thus, extensive TURP plus radiation may be the treatment of choice.