The shape-shifter: A case of pleomorphic giant cell carcinoma of prostate

Prostate cancer is the second most common cancer in men, with bone metastases in advanced cases, commonly involving the spine. Pleomorphic giant cell carcinoma (PGCC) is a rare and aggressive variant of prostate cancer. We present a 71-year-old male with a history of prostate adenocarcinoma, treated with prostatectomy, radiotherapy and androgen blockade, who developed progressive lower back pain and bilateral leg weakness. Imaging showed spinal metastases at L5-S1 and D6-D7, with spinal cord compression. Biopsy revealed a metastatic high-grade, poorly differentiated tumor, consistent with PGCC. The patient received palliative radiotherapy and supportive care. This case underscores the confounding morphology and aggressive nature of PGCC, and the need for tailored management in metastatic prostate cancer.