<i>De novo</i> large‐cell neuroendocrine carcinoma of the prostate: A case report and literature review

Fukagawa, Eri; Yuasa, Takeshi; Inamura, Kentaro; Hamada, Kosuke; Fujiwara, Motohiro; Komai, Yoshinobu; Yonese, Junji

doi:10.1002/iju5.12527

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Among the patients diagnosed with NE carcinoma-acinar adenocarcinoma mixed type who received chemotherapy in combination with ADT and the median survival time was significantly longer than that of pure LCNEPC patients ( 18 , 19 ). Another patient diagnosed with primary LCNEC combined with adenocarcinoma received ADT combined with chemotherapy with etoposide + cisplatin, and after terminating the chemotherapy was treated with abiraterone because of the high metastatic risk, and the patient was followed up for 20 months without progression ( 20 ). However, untreated cases of LCNEPC tend to progress rapidly, ultimately resulting in mortality ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Systemic metastases in large cell neuroendocrine prostate cancer: a rare case report and literature review

Xiao,

Tong,

Xiao

et al. 2024

Front. Oncol.

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Neuroendocrine prostate neoplasms, encompassing small cell carcinoma, carcinoid, and large cell carcinoma, are infrequently observed in malignant prostate tumors. The occurrence of large cell neuroendocrine prostate cancer (LCNEPC) is exceedingly rare. In this study, the patient initially presented with a persistent dysuria for a duration of one year, accompanied by a serum prostate-specific antigen (PSA) level of 17.83ng/mL. Prostate magnetic resonance imaging (MRI) and chest computed tomography (CT) scan showed that a neoplastic lesion was considered, and prostate biopsy confirmed prostate adenocarcinoma with a Gleason score of 7 (4 + 3). Then, thoracoscopic lung tumor resection was performed, and the pathological examination revealed the presence of primary moderately differentiated invasive adenocarcinoma of the lung and metastatic prostate adenocarcinoma, the Gleason score was 8 (4 + 4). After 1 year of endocrine therapy with goserelin acetate and bicalutamide, he underwent a laparoscopic radical prostatectomy (LRP), the pathological report indicated the presence of adenocarcinoma mixed with NE carcinoma. Two months after the LRP, the patient experienced gross hematuria and sacral tail pain. Further examination revealed multiple metastatic lesions throughout the body. He also underwent transurethral resection of bladder tumor (TURBT) for bladder tumor and received etoposide+ cisplatin chemotherapy three weeks post-surgery. The patient eventually died of multi-organ failure due to myelosuppression after chemotherapy. This case report presents an uncommon instance of LCNEPC with widespread systemic metastases, while also providing a comprehensive review of existing literature to facilitate improved management and treatment strategies for similar patients in subsequent cases.

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Section: Discussionmentioning

confidence: 99%

Systemic metastases in large cell neuroendocrine prostate cancer: a rare case report and literature review

Xiao,

Tong,

Xiao

et al. 2024

Front. Oncol.

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A systematic review of primary large cell neuroendocrine carcinoma of the prostate

Nguyen,

Franz,

Mohammed

et al. 2024

Front. Oncol.

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BackgroundLarge cell neuroendocrine carcinoma (LCNEC) is a rare subtype of prostate cancer. The pathogenesis, clinical manifestation, treatment options, and prognosis are uncertain and underreported.Materials and methodsA systematic search was conducted in April 2022 through PubMed, Embase, and Cochrane. We reviewed cases of LCNEC developed either from de novo or transformation from prostate adenocarcinoma and summarized the relevant pathophysiological course, treatment options, and outcomes.ResultsA total of 25 patients with a mean age of 70.4 (range 43 87 years old) from 18 studies were included in this review. 13 patients were diagnosed with de novo LCNEC of the prostate. 12 patients were from the transformation of adenocarcinoma post-hormonal therapy treatment. Upon initial diagnosis, patients diagnosed with de novo prostatic LCNEC had a mean serum PSA value of 24.6 ng/ml (range: 0.09-170 ng/ml, median 5.5 ng/ml), while transformation cases were significantly lower at 3.3 ng/ml (range: 0-9.3 ng/ml, median 0.05 ng/ml). The pattern of metastasis closely resembles prostate adenocarcinoma. Six out of twenty-three cases displayed brain metastasis matching the correlation between neuroendocrine tumors and brain metastasis. Three notable paraneoplastic syndromes included Cushings syndrome, dermatomyositis, and polycythemia. Most patients with advanced metastatic disease received conventional platinum-based chemotherapy with a mean survival of 5 months. There was one exception in the transformation cohort with a somatic BRCA2 mutation who was treated with a combination of M6620 and platinum-based chemotherapy with an impressive PFS of 20 months. Patients with pure LCNEC phenotype have worse survival outcomes when compared to those with mixed LCNEC and adenocarcinoma phenotypes. It is unclear whether there is a survival benefit to administering ADT in pure pathologies.ConclusionLCNEC of the prostate is a rare disease that can occur de novo or transformation from prostatic adenocarcinoma. Most patients present at an advanced stage with poor prognosis and are treated with conventional chemotherapy regimens. Patients who had better outcomes were those who were diagnosed at an early stage and received treatment with surgery or radiation and androgen deprivation therapy (ADT). There was one case with an exceptional outcome that included a treatment regimen of M6620 and chemotherapy.

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De novo large‐cell neuroendocrine carcinoma of the prostate: A case report and literature review

Cited by 2 publications

References 15 publications

Systemic metastases in large cell neuroendocrine prostate cancer: a rare case report and literature review

Systemic metastases in large cell neuroendocrine prostate cancer: a rare case report and literature review

A systematic review of primary large cell neuroendocrine carcinoma of the prostate

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