Kaitsumaru Masashi, Shiota Masaki, Takamatsu Dai, Blas Leandro, Matsumoto Takashi, Inokuchi Junichi, Oda Yoshinao, Eto Masatoshi
Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582 Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int Cancer Conf J. 2023 Jan 3;12(2):131-136. doi: 10.1007/s13691-022-00592-5. eCollection 2023 Apr.
A 67-year-old man with metastatic prostate cancer was treated with leuprorelin and enzalutamide, but presented radiographic progression after 1 year. Although docetaxel chemotherapy was initiated, liver metastasis appeared with elevation of nerve-specific enolase in serum. Pathological findings of needle biopsy of lymph node metastasis in the right inguinal region showed neuroendocrine carcinoma. FoundationOne CDx using a biopsy sample of the prostate at initial diagnosis detected the mutation (deletion of intron 3-7), but BRACAnalysis test revealed no mutation in germline. Then, olaparib treatment was initiated, resulting in remarkable remission of tumors, but comorbidity with interstitial pneumonia. This case suggested that olaparib could be effective for neuroendocrine prostate cancer with gene mutation, but may cause interstitial pneumonia.
一名67岁的转移性前列腺癌男性患者接受了亮丙瑞林和恩杂鲁胺治疗,但1年后出现影像学进展。尽管开始了多西他赛化疗,但出现了肝转移,血清中神经特异性烯醇化酶升高。右腹股沟区淋巴结转移的穿刺活检病理结果显示为神经内分泌癌。在初始诊断时使用前列腺活检样本进行的FoundationOne CDx检测到 突变(内含子3 - 7缺失),但BRACAnalysis检测显示胚系无 突变。然后开始奥拉帕利治疗,肿瘤显著缓解,但出现了间质性肺炎合并症。该病例提示奥拉帕利对具有 基因突变的神经内分泌前列腺癌可能有效,但可能会引起间质性肺炎。