About 95% of prostate cancers are adenocarcinomas. Neuroendocrine differentiation (NED) is seen in virtually all cases of prostatic carcinoma, mostly in a focal pattern. Extensive NED is associated to aggressive disease with a poor prognosis and most cases are diagnosed in advanced stages.We present a 79-year- old male who was admitted to our department with severe lower urinary tract obstructive symptoms and weight loss. On digital rectal examination, the prostate was fixed to the rectum with irregular margins. Serum prostate-specific antigen (PSA) level was 1.9 ng/ml.Transrectal ultrasound-guided prostate biopsies revealed small-cell carcinoma of the prostate. Multiple metastatic lesions in vertebral bones and iliac lymph nodes were detected by nuclear bone scan and abdominal computerised tomography CT. Thereafter, the patient was treated with cisplatin-based chemotherapy and palliative radiotherapy.
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