Carcinoembryonic antigen and carbohydrate antigen 19-9-producing adenocarcinoma of the prostate: Report of an autopsy case

Prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) are we ll known as specific tumor markers of prostate cancer, but carcinoembryonic antigen (CEA)and carbohydrate antigen 19-9 (CA19-9)-producing adenocarcino ma originating in the prostate is rare. We report here a case of prostatic adenocarcinoma positive for these 4 tumor markers in a 50-year-old man who had initially complained about chest pain due to metastatic bone tumor. In spite of the extensive treatment involving hormone and radiation therapy, t he patient died of rapid tumor extension only 4 months after initial diagno sis, Autopsy revealed multiple metastases to the bone, liver, lungs and lym ph nodes. Histologically, two types of adenocarcinoma were involved in both primary prostate and metastatic sites: one was a poorly differentiated ade nocarcinoma positive for PSA and PAP but not CEA or CA19-9, and the other o ne was a less differentiated adenocarcinoma partially positive for CEA and CA19-9 but not for PSA or PAP. Based on this case and previous cases by rev iew of the literature, CEA- and CA19-9-producing adenocarcinoma of the pros tate was suggested to rapidly progress with multiple metastases and to show poor prognosis with strong resistance to any treatment, Copyright (C) 2000 S. Karger AG, Basel.