Neurologic complications of patients with small cell prostate carcinoma. Report of two cases

Background. Primary small cell carcinoma arising in organs other than the lung were thought to be relatively rare. However, with the increasing technical sophistication of pathology departments, tumors with foci of small cell neuroendocrine components are being identified more frequently. The pattern of disease involvement and optimal treatment have yet to be defined. Methods. Two cases of primary small cell carcinoma of the prostate are described in which patients previously had unreported degrees of central nervous system disease. Results. Approximately 75 cases of small cell carcinoma of the prostate have been reported. Neurologic complications have been reported infrequently, although a variety of neurologic paraneoplastic sequelae have been noted. However, carcinomatous meningitis or develapment of intraductal tumors without concomitant vertebral bone disease has never been reported. These tumors respond poorly to hormonal therapy alone, and recent reports suggest optimal therapeutic strategies may involve combination hormone and chemotherapy. Conclusion. Small cell carcinoma of the prostate must be recognized when it arises de novo or with components of adenocarcinoma because the prognoses and response to treatment differs from the more common adenocarcinomas of the prostate.