Pleomorphic Giant Cell Carcinoma of the Prostate Treated With Lutetium-177 PSMA

Pleomorphic giant cell carcinoma (PGCC) of the prostate is an extremely rare and aggressive malignancy with limited treatment options. We present a case report of metastatic PGCC patients treated with ¹⁷⁷Lu-PSMA-617 radioligand therapy (Pluvicto) after progression on standard therapies. Both patients had PSMA-avid tumors on imaging. Molecular profiling revealed mutations in hallmark tumor suppressors including TP53, RB1, and PTEN. Both patients initially experienced partial radiographic response, in which one patient achieved stable disease for 9 months posttherapy. These findings suggest that PSMA-radioligand therapy may be a reasonable treatment for PGCC patients, but underscore the need for additional therapeutic options.