Clinical diagnosis and treatment of prostate basal cell carcinoma: A case report and literature review

Abstract Background: Prostate basal cell carcinoma (BCC) is a rare pathological type of prostate cancer, representing only <0.01% of malignant prostate tumors. Case presentation: A 73-year-old male patient presented to The First Affiliated Hospital of the University of Science and Technology of China (USTC) on December 28, 2020. The patient developed perineal dull pain and discomfort 15 years earlier, without obvious accompanying symptoms. The patient underwent multiple punctures and transurethral resection of the prostate (TURP), but no marked cancerization was noted, and the pain gradually worsened. Finally, puncture biopsy in the present hospital suggested BCC/adenoid cystic carcinoma (ACC) of the prostate. Pathology showed that the nuclei were relatively uniform, and the cytoplasm was scarce. Large, nested foci were observed accompanied by palisade arrangement of the surrounding cells, with necrosis in the center. Basaloid cells were irregularly arranged with small to medium solid nests. Stripes or small tubular structures were occasionally seen in which eosinophils were present. Nuclear division was rare. Based on histology and immunohistochemistry, the patient was diagnosed with prostate BCC/ACC. Because the patient had multiple distant metastases, surgery could not be performed. Hormonal therapy was performed. The patient died of bowel obstruction, intestinal perforation, and severe abdominopelvic infection 3 months later. Conclusions: Prostate BCC is a rare prostate malignant tumor, with apparently latent manifestations in the early stage and no increase in prostate-specific antigen. Therefore, it could be easy to be ignored or missed. Furthermore, biological behaviors vary, and multiple metastases in the late-stage lead to a poor prognosis.