Abstract
Prostate cancer is the leading cause of malignancy in males, and the vast majority of cases consist of androgen-sensitive acinar adenocarcinoma. Multiple relatively rare subtypes of prostate malignancy have been described, including a neuroendocrine prostate cancer, which can arise in response to androgen-deprivation treatment in the setting of existing prostatic adenocarcinoma. Neuroendocrine prostate cancer is an uncommon subtype of prostatic cancer with a highly aggressive course and lack of distinguishing features on conventional imaging. We present a case of prostatic cancer which developed into neuroendocrine prostate cancer with atypical metastatic imaging appearance and describe characteristics that may suggest a histopathologic change from the original malignancy.