NCIt definition : A lethal form of advanced castration-resistant prostate carcinoma that emerges in
the later stages of castration-resistant treatment. It is an adaptive response to
androgen receptor pathway inhibition. The morphologic features vary, ranging from
poorly differentiated carcinomas to mixed adenocarcinoma-small cell carcinomas to
pure small cell carcinomas expressing neuroendocrine markers. Clinically, it manifests
with rapidly progressive disease, visceral or lytic bone metastases and bulky tumor
masses. Molecular studies have shown the loss of tumor suppressor genes TP53 and RB1.;