Although neuroendocrine (NE) PC (NEPC) rarely arises de novo and accounts for <2% of patients at the time of PC diagnosis [5], treatment-emergent NEPC (t-NEPC) has been recently recognized to be observed in later stages of PC progression in up to 15–20% of patients treated with AR signaling-targeted agents (ARSTAs), including abiraterone acetate and enzalutamide, in the metastatic and castration-resistant disease state [6,7,8]. Here, AR is linked to pachyonychia congenita.