Dong Shiqiang, Liu Qing, Xu Zihan, Wang Haitao
Department of Oncology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China.
Front Oncol. 2020 May 27;10:859. doi: 10.3389/fonc.2020.00859. eCollection 2020.
Primary basal cell carcinoma (BCC) is a rare prostate cancer. Currently, a standard treatment regime for BCC of the prostate is lacking and most patients have a poor prognosis. We reported on a patient with BCC of the prostate whose cancer metastasized after undergoing a radical prostatectomy and whose prognosis improved after treatment with etoposide. A 62-year-old male with a history of seminoma was admitted complaining of intermittent gross hematuria for 1 month. Following a prostate biopsy, the patient was diagnosed with BCC of the prostate and received radical prostatectomy and radiotherapy. Initially, the patient's symptoms improved; however, 2 years later, a chest computed tomography (CT) scan revealed lung nodules. The patient did not exhibit any symptoms of BCC of the prostate; however, pathological examination and immunohistochemical staining of the nodules confirmed metastatic BCC of the prostate. Chemotherapy with docetaxel and cisplatin was well-tolerated but did not slow disease progression. Next-generation sequencing revealed mutations in the ataxia telangiectasia-mutated (), SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily b-member 1 (, and phosphoinositide-3-kinase regulatory subunit 1 () genes. The patient did not receive targeted therapy owing to financial limitations and instead, etoposide was administered. A 9-month follow-up chest CT scan showed an 80% reduction in existing lung nodules and no new nodules had developed. Our patient, diagnosed with recurrent prostate BCC after receiving a radical prostatectomy, responded to treatment with etoposide. Radical prostatectomy and radiotherapy should remain first-line therapy; however, etoposide may be an alternative second-line therapy when other options are not available. Consensus regarding treatment plans, and the molecular mechanisms behind prostate BBC, must be elucidated.
原发性基底细胞癌(BCC)是一种罕见的前列腺癌。目前,缺乏针对前列腺BCC的标准治疗方案,大多数患者预后较差。我们报告了一名前列腺BCC患者,其癌症在接受根治性前列腺切除术后发生转移,经依托泊苷治疗后预后改善。一名有精原细胞瘤病史的62岁男性因间歇性肉眼血尿1个月入院。前列腺活检后,该患者被诊断为前列腺BCC,并接受了根治性前列腺切除术和放疗。最初,患者症状有所改善;然而,2年后,胸部计算机断层扫描(CT)显示肺部有结节。该患者没有表现出前列腺BCC的任何症状;然而,对结节进行的病理检查和免疫组化染色证实为前列腺转移性BCC。多西他赛和顺铂化疗耐受性良好,但并未减缓疾病进展。二代测序显示共济失调毛细血管扩张突变()、SWI/SNF相关基质相关肌动蛋白依赖性染色质调节因子亚家族b成员1()和磷酸肌醇-3-激酶调节亚基1()基因发生突变。由于经济限制,该患者未接受靶向治疗,而是给予了依托泊苷。9个月的随访胸部CT扫描显示,现有肺部结节减少了80%,且没有新的结节出现。我们的患者在接受根治性前列腺切除术后被诊断为复发性前列腺BCC,对依托泊苷治疗有反应。根治性前列腺切除术和放疗应仍然是一线治疗;然而,当没有其他选择时,依托泊苷可能是一种替代的二线治疗。必须阐明关于治疗方案以及前列腺BBC背后分子机制的共识。