Weng XT, Lin WL, Pan QM, Chen TF, Li SY, Gu CM. Aggressive variant prostate cancer: A case report and literature review. World J Clin Cases 2023; 11(26): 6213-6222 [PMID: 37731555 DOI: 10.12998/wjcc.v11.i26.6213]
Corresponding Author of This Article
Chi-Ming Gu, MD, Chief Physician, Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, NO. 111 Dade Road, Yuexiu District, Guangzhou 510000, Guangdong Province, China. guchiming@gzucm.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiang-Tao Weng, Si-Yi Li, Chi-Ming Gu, Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Wen-Li Lin, Qi-Man Pan, Tao-Fen Chen, Department of Urology, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Author contributions: Weng XT and Lin WL contributed equally to this work; Weng XT and Lin WL wrote and edited the manuscript; Pan QM contributed to data acquisition; Chen TF and Li SY contributed to technical and material support; Gu CM contributed to critical revision, obtaining funding and approval of the final manuscript; All authors have read and approved the final manuscript.
Supported byGuangdong Provincial Hospital of Traditional Chinese Medicine, NO 2022KT1166 and NO 2018KT1635; Guangdong Provincial Bureau of Traditional Chinese Medicine, NO 2021KT1500; and Guangzhou Science and Technology Bureau, NO 202201020350.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chi-Ming Gu, MD, Chief Physician, Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, NO. 111 Dade Road, Yuexiu District, Guangzhou 510000, Guangdong Province, China. guchiming@gzucm.edu.cn
Received: May 14, 2023 Peer-review started: May 14, 2023 First decision: July 17, 2023 Revised: July 29, 2023 Accepted: August 15, 2023 Article in press: August 15, 2023 Published online: September 16, 2023 Processing time: 116 Days and 23 Hours
Abstract
BACKGROUND
Aggressive variant prostate cancer (AVPC) is a rare disease that progresses rapidly. The first-line treatment for AVPC is currently unknown. We examined a rare case of AVPC with rare brain and bladder metastases. A summary review of the mechanism of development, clinicopathological manifestations, associated treatments and prognosis of this disease is presented.
CASE SUMMARY
The patient was diagnosed with prostate cancer (PCA), and was actively treated with endocrine therapy, radiotherapy, chemotherapy, and traditional Chinese medicine. Unfortunately, he was insensitive to treatment, and the disease progressed rapidly. He died five years after being diagnosed with PCA.
CONCLUSION
We should reach consensus definitions of the AVPC and other androgen receptor-independent subtypes of PCA and develop new biomarkers to identify groups of high-risk variants. It is crucial to complete a puncture biopsy of the tumor or metastatic lesion as soon as possible in patients with advanced PCA who exhibit clinical features such as low Prostate-specific antigen levels, high carcinoembryonic antigen levels, and insensitivity to hormones to determine the pathological histological type and to create a more aggressive monitoring and treatment regimens.
Core Tip: This article reviews the literature and summarizes the characteristics and research progress of the rare clinical subtype, aggressive variant prostate cancer (AVPC), especially the treatment regimen. AVPC has low prostate-specific antigen levels, is hormone refractory, is aggressive, manifests as rare brain and bladder metastases, and has a very poor clinical prognosis. The first-line regimen for AVPC is currently unclear, with platinum-based chemotherapy regimens as the mainstay of intervention at this stage. Liquid biopsy, gene detection and molecular imaging are currently hot research topics that can provide guidance for the clinical treatment of advanced prostate cancer. This report aims to serve as a reference for clinicians.
