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SEER Inquiry System - Report
Produced: 09/14/2025 2:37 AM
Question 20240010
Inquiry Details
References:
#1: Solid Tumor Rules. Other Sites, 2025 Update
#2: WHO Class Male Genital Tumors, 223-224. 5th edition
Question:
Solid Tumor Rules/Histology--Prostate: Other Sites Solid Tumor RulesTable 3 (Prostate Histologies), Note 1 in the Adenocarcinoma with neuroendocrine differentiation (8574/3) row, conflicts with Note 2 and requires further clarification. See Discussion.
Discussion:
Note 1 states that this histology is treatment-related neuroendocrine prostatic carcinoma demonstrating complete neuroendocrine differentiation or partial neuroendocrine differentiation with adenocarcinoma after androgen-deprivation therapy (ADT). Conversely, Note 2 says to code 8574/3 only when there is no history of previous prostate adenocarcinoma or history of androgen-deprivation therapy.
The WHO Blue Book does confirm this is a treatment-related histology, so it seems we would only use this for an adenocarcinoma with neuroendocrine differentiation (or even possibly a mixed histology tumor with adenocarcinoma and small cell carcinoma components) if the patient had previous treatment.
If this histology is treatment-related, why would we use this code for a patient without a history of prostate adenocarcinoma or androgen-deprivation therapy? Should Note 2 be corrected?
Does this histology apply to a post-treatment diagnosis of mixed adenocarcinoma and small cell carcinoma? If yes, should this clarification be added?
Answer:
Answer updated September 2025
Per consultation with a male genital and urinary subject matter expert pathologist, if a patient with a previous diagnosis of acinar adenocarcinoma (or a subtype variant of 8140/3) of the prostate was treated with radiation and/or androgen deprivation therapy (ADT, a form of hormonal therapy), the following subsequent diagnoses are NOT a new primary.
- Adenocarcinoma with neuroendocrine differentiation (8574/3)
- Adenosquamous carcinoma (8560/3)
- Small cell carcinoma (8041/3)
- Squamous cell carcinoma (8070/3)
For example, a patient is diagnosed with acinar adenocarcinoma and undergoes hormone therapy. Two years later, the patient is diagnosed with adenosquamous carcinoma. The adenosquamous carcinoma should be considered treatment-related and is not a new primary.
