2020-42 / October 19
Contributors: Liwei Jia
A man in his mid 60s had a prior history of prostatic adenocarcinoma (Gleason score 5+5=10, involving 12 cores). His PSA level initially declined to undetectable after introducing treatment with abiraterone + prednisone 1.5 years ago. He now presents with rising PSA level and has evidence of new bone metastases identifiable on CT imaging. A TURP was performed to relieve his urinary symptoms.
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1. What is the correct diagnosis?
a. Prostatic acinar adenocarcinoma, Gleason score 5+3=8 (Grade Group 4)
b. Prostatic acinar adenocarcinoma with metastatic small cell carcinoma
c. Mixed prostatic acinar adenocarcinoma with small cell carcinoma
d. Prostatic acinar adenocarcinoma with neuroendocrine differentiation