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Case of the Week

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.

Click on the below thumbnails to enlarge photos.

5 photo(s) Updated on: October 15, 2020
  • Chromogranin
  • Synaptophysin


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

About GUPS

The Genitourinary Pathology Society (GUPS) was formed with the vision of advancing the care of patients with urologic diseases through enhancements of best practices, research, and education in the subspecialty of Urological Pathology.

GUPS is an official Companion Society of the United States and Canadian Academy of Pathology (USCAP).



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