前列腺小细胞神经内分泌癌患者一例报道并文献复习

目的探讨前列腺小细胞神经内分泌癌的临床诊断和治疗。 方法回顾性分析我院收治的1例前列腺小细胞神经内分泌癌患者的资料。结合相关文献讨论前列腺神经内分泌肿瘤的病理学分型、临床表现、影像学特征、诊治和预后。 结果患者男性，64岁，2014年9月因发现PSA 52.72 μg/L，前列腺穿刺活检提示前列腺腺泡腺癌，Gleason评分3+4=7分，予手术去势，后联合持续抗雄治疗（比卡鲁胺50 mg qd）。2017年5月复查发现盆腔巨大肿物伴肠梗阻，全身多发骨转移、肝脏转移、肺转移。予盆腔肿物切除+横结肠造瘘，术后病理提示前列腺小细胞内分泌癌。患者术后2周开始予多西他赛100 mg d1+卡铂450 mg d1，化疗2周期后因多脏器功能衰竭去世。 结论前列腺癌伴神经内分泌分化为最常见的前列腺神经内分泌肿瘤，前列腺小细胞癌临床罕见，早期手术联合化疗为主要治疗手段，肿瘤恶性程度高、进展快，预后差。

Small-cell neuroendocrine prostate cancer: one case report and literature review

ObjectiveTo evaluate the clinical and pathological characteristics of small-cell neuroendocrine prostate cancer. MethodsThe clinical data of one case with small-cell neuroendocrine prostate cancer were evaluated, and literature review was foused on the pathological diagnosis, clinical manifestation, imaging characteristics, treatment and prognosis for this rare disease. ResultsThe patient was male, 64 years old. In early 2014, biopsy was advised because of elevated PSA of 52.72 μg/L. The pathology for biopsy was prostate adenocarcinoma, Gleason score 3+4=7. Surgical castration was suggested. In May 2017, the patient was manifested with pelvic giant mess accompanied with intestinal obstruction, multiple bone metastasis, liver metastasis and lung metastasis. After tumor resection and colon fistula, postoperative pathology suggested small cell carcinoma. The patient was given chemotherapy with docetaxel and carboplatin after surgery and died of multiple organ failure after 2 cycles. ConclusionProstate cancer with neuroendocrine differentiation is the most common prostate neuroendocrine tumor, however, the subtype of prostate small cell carcinoma is rare. Early surgery combined with chemotherapy is the main treatment. Cancer is usually manifested with high malignancy, rapid progression and poor prognosis.