巨大な前立腺小細胞癌の1例

Abstract

症例は64歳で, 腰痛と溢流性尿失禁を主訴とした.腹部骨盤部CTで最大横径107mm, 最大前後径90mmの巨大前立腺を認め, 生検で小細胞癌と診断した.第5腰椎体と左眼窩内に破骨性転移を認めた.LH-RHアナログとフルタミドによるホルモン療法に加え少量シスプラチン投与を行ったところ一時的に全身状態の改善が得られたが, 徐々に意識不明となり39℃以上の腫瘍熱が持続して第74病日に死亡した

A 64-year-old man having backbone pain was referred to our institute, and laboratory examinations revealed that he was suffering from severe renal failure. Abdomino-pelvic CT revealed bilateral hydronephrosis, a giant prostate over 500 g in weight, and multiple para-aortic lymph node metastasis. Histological diagnosis of the prostate was small cell neuroendocrine carcinoma. Serum neuron-specific enolase (NSE) level was slightly high reflecting the positive immunohistochemical staining, but serum PSA remained within normal limits. The patient was treated with hormone-chemotherapy after successful treatment of the renal failure, but he died on the 74th hospital day. Small cell carcinoma is known to have a high rate of malignancy and metastasis from an early stage. Several giant prostatic tumors have been reported previously, but this case is considered to be the second gigantic small cell carcinoma in the Japanese literature.