集学的治療にて比較的長期予後を得られている前立腺小細胞癌の1例

Abstract

A 72-year-old Japanese man was referred to a hospital because of urinary retention. Digital rectal examination revealed a stony, hard nodule in the prostate. A high level of serum PSA was not detected. Prostatic biopsy was performed, and pathological examination indicated adenocarcinoma of the prostate. He was referred to our hospital for treatment. Imaging examinations revealed no metastases (T4N0M0), so we re-evaluated the biopsy specimens. Immunohistochemical examination revealed prostatic small cell carcinoma. His levels of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide (Pro-GRP) were high. We treated him with combination chemotherapy comprising irinotecan and cisplatin, and the treatment waseffective. After four coursesof the chemotherapy, levelsof NSE and Pro-GRP had decreased, and the prostatic mass had decreased in size. Needle rebiopsy of the prostate demonstrated no evidence of malignancy. Adjuvant external beam radiation therapy wasals o performed. The patient iss till alive at 18 month after diagnosis with no evidence of relapse or metastasis of the disease.