Case report: squamous cell carcinoma of the prostate-a clinicopathological and genomic sequencing-based investigation
Description
Squamous differentiation of prostate cancer, which accounts for less than 1% of all cases, is typically associated with androgen deprivation treatment (ADT) or radiotherapy. This entity is aggressive and exhibits poor prognosis due to limited response to traditional treatment. However, the underlying molecular mechanisms and etiology are not fully understood. Previous findings suggest that squamous cell differentiation may potentially evolve from prostate adenocarcinoma (AC), as four cases of squamous cell carcinoma (SCC) of the prostate were detected with ERG pathway activation, but further validation is needed to confirm this hypothesis. This paper presents a case of advanced prostate cancer with a combined histologic pattern, including keratinizing SCC and AC. The study utilized whole-exome sequencing (WES) data to analyze both subtypes and identified significant genetic overlap between the two, despite having a non-ERG activation molecular signature. This discovery supports previous research that suggests squamous differentiation develops from prostate adenocarcinoma. Moreover, the transformation to squamous cell carcinoma in the prostate may involve various molecular pathways such as the reactivation of the AR pathway, genome instability, and abnormal R-loop formation. This indicates the need for individualized clinical management of prostate SCC, and specific molecular findings may aid in optimizing treatment strategies.