Abstract:
A 71-year-old man with bone metastasis of hormone-sensitive prostate cancer was treated with androgen deprivation therapy and apalutamide. Radium-223 and radiation therapy were administered after it become castration resistant. Although prostate-specific antigen levels remained low, multiple subcutaneous metastases of neuroendocrine prostate cancer were observed. A review of the pre-treatment prostate needle biopsy revealed a small component with features suggestive of neuroendocrine differentiation. Phosphatase and tensine homolog loss and tumor protein p53 overexpression were observed, confirming the diagnosis of aggressive variant prostate cancer. Platinum-based chemotherapy was administered; however, the patient died 28 months after diagnosis. In this case, if the diagnosis of aggressive variant prostate cancer had been made at an earlier time by biopsy specimens, there might have been a possibility to improve the prognosis by the earlier introduction of the platinum-based regimen.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s13691-024-00673-7.
摘要:
一名71岁的激素敏感型前列腺癌骨转移患者接受了雄激素剥夺疗法和阿帕鲁胺治疗。镭-223和放射治疗在其变得去势抵抗后进行。尽管前列腺特异性抗原水平仍然很低,观察到神经内分泌前列腺癌的多个皮下转移。对治疗前前列腺穿刺活检的回顾显示,一小部分具有提示神经内分泌分化的特征。观察到磷酸酶和tensine同源物的丢失和肿瘤蛋白p53的过度表达,确认侵袭性变异型前列腺癌的诊断。给予以铂为基础的化疗;然而,患者在诊断后28个月死亡.在这种情况下,如果侵袭性变异型前列腺癌的诊断是在较早的时间通过活检标本做出的,较早引入以铂类药物为基础的治疗方案可能会改善预后.
■在线版本包含补充材料,可在10.1007/s13691-024-00673-7获得。