Adenocarcinoma of the prostate involving 2 cell types (prostate specific antigen producing and carcinoembryonic antigen producing) with selective metastatic spread.

Of 3 patients with clinically localized adenocarcinoma of the prostate 2 were treated by radical prostatectomy and 1 was treated with radiation therapy. Serum prostate specific antigen (PSA) values were elevated before therapy. After treatment the PSA levels were decreased to zero. All 3 patients later had evidence of metastatic tumor spread to the liver with elevation of serum carcinoembryonic antigen but not PSA. Immunohistochemical staining of the 2 primary tumors from the prostatectomy specimens identified 2 cell clones, one immunoreactive to PSA and prostatic acid phosphatase (PAP) and nonimmunoreactive to carcinoembryonic antigen, and the other immunoreactive to carcinoembryonic antigen but not PSA or PAP. Biopsy of a hepatic metastasis in 2 patients confirmed anaplastic carcinoma of the carcinoembryonic antigen-producing cell type. Immunohistochemical staining of a lymph node metastasis identified the PSA-producing cell type only. Such results suggest selective metastatic spread of each cell type to its own organ tropic site. Occasional carcinoembryonic antigen-producing prostate cancers may metastasize to the liver. Serum carcinoembryonic antigen measurements occasionally may be useful in the management of certain prostate adenocarcinoma patients.
AuthorsD A Guthman, G M Farrow, R P Myers, R G Ferrigni, M M Lieber
JournalThe Journal of urology (J Urol) Vol. 146 Issue 3 Pg. 854-6 (Sep 1991) ISSN: 0022-5347 [Print] UNITED STATES
PMID1714970 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Prostate-Specific Antigen
  • Adenocarcinoma (immunology, pathology, secondary)
  • Aged
  • Antigens, Neoplasm (analysis)
  • Biomarkers, Tumor (analysis)
  • Carcinoembryonic Antigen (analysis)
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Prostate-Specific Antigen
  • Prostatic Neoplasms (immunology, pathology)

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