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Erschienen in: International Journal of Clinical Oncology 6/2011

01.12.2011 | Case Report

Complete remission in a patient with metastatic mixed adenocarcinoma/extrapulmonary small cell carcinoma of the prostate

verfasst von: Jonathan Edward Brammer, Premal Lulla, Garrett Rush Lynch

Erschienen in: International Journal of Clinical Oncology | Ausgabe 6/2011

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Abstract

Approximately 10% of all extra-pulmonary small cell carcinoma (EPSCC) arises in the prostate either as de novo mixed adenocarcinoma with small cell components or a pure small cell carcinoma. Extensive disease carries a median survival of about 10 months in retrospective studies. We present a case managed aggressively with concomitant hormonal and chemotherapy, now 36 months without evidence of disease. At a routine physical, a 55 year male was found to have a 5 cm left upper lobe lung mass, invading his 3rd rib. An FNA revealed an adenocarcinoma of unknown primary. His PSA was elevated to 8 ng/mL and a prostate biopsy revealed Gleason 9 adenocarcinoma with neuro-endocrine/SCC components. A bone scan revealed extensive bone metastasis. He was managed aggressively with concomitant cisplatin, etoposide and hormonal therapy and received 73 Gy of radiation to the prostate. PET scans demonstrated marked response to chemotherapy. PSA and chromogrannin levels down trended to normal limits. His most recent PET scan in July 2010 revealed no evidence of disease and is in remission. We present a unique case of metastatic mixed adenocarcinoma/SCC of the prostate, in which the patient survived more than 36 months with complete remission after initiation of aggressive hormonal and chemotherapy. Data on survival in this patient population is limited to case reports, and ordinarily carries a poor prognosis of less than 1 year. In patients with clinical and pathologic features of mixed disease, initiation of early multi-modal therapy is warranted. Additionally, it may be of prognostic significance to biopsy any metastatic lesion.
Literatur
1.
Zurück zum Zitat Walenkamp AM, Sonke GS, Sleijfer DT (2009) Clinical and therapeutic aspects of extrapulmonary small cell carcinoma. Cancer Treat Rev 35:228–236PubMedCrossRef Walenkamp AM, Sonke GS, Sleijfer DT (2009) Clinical and therapeutic aspects of extrapulmonary small cell carcinoma. Cancer Treat Rev 35:228–236PubMedCrossRef
2.
Zurück zum Zitat Haider K, Shahid RK, Finch D et al (2006) Extrapulmonary small cell cancer: a Canadian province’s experience. Cancer 07:2262–2269CrossRef Haider K, Shahid RK, Finch D et al (2006) Extrapulmonary small cell cancer: a Canadian province’s experience. Cancer 07:2262–2269CrossRef
3.
Zurück zum Zitat Asmis TR, Reaume MN, Dahrouge S et al (2006) Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at the Ottawa Hospital Regional Cancer Center. BJU Int 97:711–715PubMedCrossRef Asmis TR, Reaume MN, Dahrouge S et al (2006) Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at the Ottawa Hospital Regional Cancer Center. BJU Int 97:711–715PubMedCrossRef
4.
Zurück zum Zitat Mackey JR, Au JH, Hugh J et al (1998) Genitourinary small cell carcinoma: determination of clinical and therapeutic factors associated with survival. J Urol 159:1624–1629PubMedCrossRef Mackey JR, Au JH, Hugh J et al (1998) Genitourinary small cell carcinoma: determination of clinical and therapeutic factors associated with survival. J Urol 159:1624–1629PubMedCrossRef
5.
Zurück zum Zitat Spiess PE, Pettaway CA, Vakar-Lopez F et al (2007) Treatment outcomes of small cell carcinoma of the prostate: a single-center study. Cancer 110:1729–1737PubMedCrossRef Spiess PE, Pettaway CA, Vakar-Lopez F et al (2007) Treatment outcomes of small cell carcinoma of the prostate: a single-center study. Cancer 110:1729–1737PubMedCrossRef
6.
Zurück zum Zitat Yao JL, Huang J, Sante’Agnese PA (2008) Small cell carcinoma of the prostate. Diagn Histopathol 14:117–121CrossRef Yao JL, Huang J, Sante’Agnese PA (2008) Small cell carcinoma of the prostate. Diagn Histopathol 14:117–121CrossRef
7.
Zurück zum Zitat Moore SR, Reinberg Y, Zhang G (1992) Small cell carcinoma of prostate: effectiveness of hormonal versus chemotherapy. Urology 39:411–416PubMedCrossRef Moore SR, Reinberg Y, Zhang G (1992) Small cell carcinoma of prostate: effectiveness of hormonal versus chemotherapy. Urology 39:411–416PubMedCrossRef
8.
Zurück zum Zitat Deftos LF, Nakada S, Burton DW et al (1996) Immunoassay and immunohistology studies of chromogranin A as a neuroendocrine marker in patients with carcinoma of the prostate. Urology 48:58–62PubMedCrossRef Deftos LF, Nakada S, Burton DW et al (1996) Immunoassay and immunohistology studies of chromogranin A as a neuroendocrine marker in patients with carcinoma of the prostate. Urology 48:58–62PubMedCrossRef
9.
Zurück zum Zitat Isshiki S, Akakura K, Komiya A et al (2002) Chromogranin A concentration as a serum marker to predict prognosis after endocrine therapy for prostate cancer. J Urol 167:512–515PubMedCrossRef Isshiki S, Akakura K, Komiya A et al (2002) Chromogranin A concentration as a serum marker to predict prognosis after endocrine therapy for prostate cancer. J Urol 167:512–515PubMedCrossRef
10.
Zurück zum Zitat 2011 NCCN Clinical Practice Guidelines in Oncology: prostate cancer, version 1.2011 PROS-8 2011 NCCN Clinical Practice Guidelines in Oncology: prostate cancer, version 1.2011 PROS-8
11.
Zurück zum Zitat Stein M, Bernstein Z, Abacioglu U et al (2008) Small cell (neuroendocrine) carcinoma of the prostate: etiology, diagnosis, and prognosis, and therapeutic implications—a retrospective study of 30 patients from the rare cancer network. Am J Med Sci 336:478–488PubMedCrossRef Stein M, Bernstein Z, Abacioglu U et al (2008) Small cell (neuroendocrine) carcinoma of the prostate: etiology, diagnosis, and prognosis, and therapeutic implications—a retrospective study of 30 patients from the rare cancer network. Am J Med Sci 336:478–488PubMedCrossRef
Metadaten
Titel
Complete remission in a patient with metastatic mixed adenocarcinoma/extrapulmonary small cell carcinoma of the prostate
verfasst von
Jonathan Edward Brammer
Premal Lulla
Garrett Rush Lynch
Publikationsdatum
01.12.2011
Verlag
Springer Japan
Erschienen in
International Journal of Clinical Oncology / Ausgabe 6/2011
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-011-0198-2

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