Hashine K, Nakatsuji H, Karashima T, Sumiyoshi Y, Mandai K, Hata A
Department of Urology, National Shikoku Cancer Center Hospital.
Hinyokika Kiyo. 1998 Aug;44(8):607-10.
A 57-year-old man was admitted with the chief complaint of macrohematuria. Digital rectal examination showed a slightly enlarged, irregular prostate with stony consistency. Serum levels of prostate specific antigen (PSA), neuron-specific enolase (NSE) and progastrin-releasing peptide (ProGRP) were elevated. Transurethral resection (TUR)-biopsy of the prostate revealed small cell carcinoma with poorly differentiated adenocarcinoma. Various radiological examinations revealed metastases to pelvic lymph nodes and liver. He was treated with chemoendocrine therapy consisting of cisplatin, etoposide, flutamide and luleinizing hormone-releasing hormone (LH-RH) agonist. The primary tumor and metastatic lesion decreased and serum PSA, NSE and ProGRP levels were decreased to normal ranges after 5 cycles of chemotherapy. After the 5-cycle chemotherapy, TUR-biopsy proved viable tumor cells. During the additional chemotherapy, tumor markers increased and 4 months later liver metastasis progressed. He died 13 months after diagnosis of small cell carcinoma of the prostate.
一名57岁男性因肉眼血尿为主诉入院。直肠指检显示前列腺稍大、不规则,质地坚硬如石。血清前列腺特异性抗原(PSA)、神经元特异性烯醇化酶(NSE)和胃泌素释放肽前体(ProGRP)水平升高。经尿道前列腺切除术(TUR)活检显示为小细胞癌伴低分化腺癌。各种影像学检查显示有盆腔淋巴结和肝脏转移。他接受了由顺铂、依托泊苷、氟他胺和促黄体生成素释放激素(LH-RH)激动剂组成的化疗内分泌治疗。5个周期化疗后,原发肿瘤和转移灶缩小,血清PSA、NSE和ProGRP水平降至正常范围。5周期化疗后,TUR活检证实仍有存活的肿瘤细胞。在后续化疗期间,肿瘤标志物升高,4个月后肝转移进展。前列腺小细胞癌诊断13个月后他死亡。