Case Report / Olgu Sunumu ©Copyright 2017 by Urooncology Association Bulletin of Urooncology / Published by Galenos Yayınevi 67 Bulletin of Urooncology 2017;16:67-69 DOI: 10.4274/uob.771 Introduction Prostate carcinosarcoma is extremely rare and aggressive neoplasm. It constitutes approximately 0.1% of all neoplasias of prostate, and mostly seen in 6 th and 7 th decades (1). As its name denotes, it contains sarcomatoid and malign epithelial components (2). Epithelial component exhibits different Gleason patterns and prostate-specific antigen (PSA) staining is positive. Sarcomatous component is usually composed of nonspecific spindle cells. Heterologous differentiation can be observed with chondrosarcoma, osteosarcoma, leiomyosarcoma, rhabdomyosarcoma, liposarcoma or any combinations thereof (2). Serum PSA levels are usually within normal limits (3). Prostate adenocarcinoma previously seen in 50% of cases. Carcinosarcoma can develop secondary to hormonal therapy and radiotherapies (4). Lung and liver metastases are common. Nowadays, a small number of prostate carcinosarcoma cases have been reported in the literature (5). Therefore, there is no standard treatment protocol. Here, we defined a 78-year old carcinosarcoma developed at 3 rd year of hormonal treatment. Case Presentation A 78 year-old man with prostate adenocarcinoma referred to our department with lower urinary tract symptoms and macroscopic hematuria. The patient was diagnosed with prostate adenocarcinoma 3 years ago. The serum PSA level was 65 ng/mL, the initial prostate biopsy revealed prostate adenocarcoma of Gleason 4+3. No report was available regarding metastatic evaluation. Combined androgen blockade with goserelin and bicalutamide was started three years ago. The patient had urethral catheter for 2 months. The last serum PSA level was 1.21 ng/mL. On digital rectal exam, a stony hard prostate fixed to the surrounding tissue was palpated. Cystoscopy revealed a gross hematoma in the bladder without any lesion. The patient underwent transurethral prostate resection and bilateral orchiectomy. No metastasis was detected on thoracic and abdominal computed tomography. Histopathological examination revealed carcinosarcoma of prostate. Histologically, the tumor was found to consist of a mixture of bizarre like cells; atypical, pleomorphic spindle cells with many atypical mitosis and some areas of osteoid-like appearance (Figure 1). Epithelial component was found in a small area. Epithelial cells were positive for cytokeratin pan- antibody whereas the other areas were negative. Sarcomatous components were stained positive for vimentin, CD68, smooth muscle actin; negative for CD34, S100, PSA, desmin (Figure 2). The patient was discharged from our hospital with urethral catheter due to a lack of urination spontaneously. There was Prostat karsinosarkomu, sarkomatöz ve karsinomatöz unsurlardan oluşan nadir bir malignitedir. Sıklıkla kötü prognozu olan çok agresif tümörlerdir. Bu olgu sunumunda, 3 yıl maksimum androjen blokajı alan prostat adenokarsinomu olgusunda prostat karsinosarkomu gelişen 78 yaşındaki bir erkek hasta sunuldu. Bu nadir görülen malignitenin klinik ve patolojik özelliklerini güncel bilgilerle tanımlamaya çalıştık. Anahtar Kelimeler: Prostat, karsinosarkom, adenokarsinom Öz Prostatic carcinosarcoma is a rare malignancy composed of sarcomatous and carcinomatous elements. Predominantly, they are very aggressive tumors with a poor prognosis. In this case report, a 78 year-old male patient with prostate adenocarcinoma developing prostatic carcinosarcoma after using androgen blockade for 3 years was presented. We tried to define the clinical and pathological features of this rare malignancy with current information. Keywords: Prostate, carcinosarcoma, adenocarcinoma Abstract Address for Correspondence/Yaz›flma Adresi: Yusuf Şenoğlu MD, Aliağa State Hospital, Clinic of Urology, İzmir, Turkey Phone: +90 232 616 87 87 E-mail: ysenoglu@yahoo.com Received/Geliş Tarihi: 23.11.2016 Accepted/Kabul Tarihi: 15.02.2017 1 Aliağa State Hospital, Clinic of Urology, İzmir, Turkey 2 Marmara University, Pendik Training and Research Hospital, Clinic of Urology, İstanbul, Turkey 3 Düzce University Faculty of Medicine, Department of Pathology, Düzce, Turkey 4 Düzce University Faculty of Medicine, Department of Urology, Düzce, Turkey Yusuf Şenoğlu MD 1 , Kamil Çam MD 2 , Havva Erdem MD 3 , Muhammet Ali Kayıkçı MD 4 , Ali Tekin MD 4 Prostat Karsinosarkomu: Olgu Sunumu Prostatic Carcinosarcoma: A Case Report