Frontiers in urology · 2026
Case Report: cytoreductive prostatectomy after platinum-etoposide chemotherapy for de novo metastatic prostatic small cell neuroendocrine carcinoma.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Yanxin, Wang Qiwu, Yang Hang
Аннотация
OBJECTIVE: To describe the diagnostic challenges, treatment response, and potential benefits and risks of cytoreductive surgery in de novo metastatic prostatic small cell neuroendocrine carcinoma (SCNEC).
METHODS: We retrospectively reviewed the clinical course of one patient with de novo metastatic prostatic SCNEC.
RESULTS: A 50-year-old man presented in June 2022 with progressive dysuria for more than 1 year and acute urinary retention for 1 day. Transurethral resection of the prostate (TURP) was performed to relieve obstruction, and review of the specimen supported SCNEC. Staging 18F-FDG PET/CT showed an FDG-avid prostate, multiple lymph nodes, and bilateral non-FDG-avid pulmonary nodules without a dominant pulmonary primary; a prostatic primary with clinically suspected pulmonary metastases was favored, although the lung lesions were not biopsied. Seven cycles of etoposide plus cisplatin (EP) produced marked local regression, including a reduction in prostate volume from 72 to 17 cm³, but residual tumor persisted and a RECIST response category could not be assigned retrospectively. Cytoreductive laparoscopic radical prostatectomy was performed in February 2023. Postoperative pathology showed a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). A vesicourethral anastomotic leak improved conservatively, and urinary obstruction improved for approximately 3 months. Disease progressed in July 2023, and irinotecan plus carboplatin provided no durable clinical disease control. The patient died in December 2023, approximately 18 months after diagnosis.
CONCLUSION: EP can produce substantial but temporary regression in metastatic prostatic SCNEC. This case did not establish a survival benefit from surgery, although temporary relief of urinary obstruction was reported. Systemic therapy should remain the priority, and surgery should be limited to carefully selected local-control or palliative indications.
METHODS: We retrospectively reviewed the clinical course of one patient with de novo metastatic prostatic SCNEC.
RESULTS: A 50-year-old man presented in June 2022 with progressive dysuria for more than 1 year and acute urinary retention for 1 day. Transurethral resection of the prostate (TURP) was performed to relieve obstruction, and review of the specimen supported SCNEC. Staging 18F-FDG PET/CT showed an FDG-avid prostate, multiple lymph nodes, and bilateral non-FDG-avid pulmonary nodules without a dominant pulmonary primary; a prostatic primary with clinically suspected pulmonary metastases was favored, although the lung lesions were not biopsied. Seven cycles of etoposide plus cisplatin (EP) produced marked local regression, including a reduction in prostate volume from 72 to 17 cm³, but residual tumor persisted and a RECIST response category could not be assigned retrospectively. Cytoreductive laparoscopic radical prostatectomy was performed in February 2023. Postoperative pathology showed a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). A vesicourethral anastomotic leak improved conservatively, and urinary obstruction improved for approximately 3 months. Disease progressed in July 2023, and irinotecan plus carboplatin provided no durable clinical disease control. The patient died in December 2023, approximately 18 months after diagnosis.
CONCLUSION: EP can produce substantial but temporary regression in metastatic prostatic SCNEC. This case did not establish a survival benefit from surgery, although temporary relief of urinary obstruction was reported. Systemic therapy should remain the priority, and surgery should be limited to carefully selected local-control or palliative indications.