Mădălina-Cristina Negulescu1, Mihaela Mihai2, Iulia Magdalena Gramaticu1
1Department of Oncology, Fundeni Clinical Institute, Bucharest, Romania
2Department of Pathology, Fundeni Clinical Institute, Bucharest, Romania
Corresponding author: Iulia Gramaticu, Email: email@example.com
Published: Volume II, Issue 2, December 2022, 38-45, , , - DOI: 10.53011/JMRO.2022.02.06
Poorly differentiated neuroendocrine carcinomas are rare. Most of them arise from the lung, and only 9% are found in extrapulmonary sites. In the prostate, neuroendocrine cells are more commonly present compared to other organs of the genitourinary tract.
We present the case of a 67-year-old male patient who was investigated for constipation, loss of appetite and pelvic-perineal pain; a large prostatic mass was discovered upon further investigation. After a thorough work-up and multidisciplinary approach, the patient was diagnosed with de novo small cell neuroendocrine carcinoma of the prostate with multiple metastases. He underwent five cycles of chemotherapy with cisplatin and etoposide before we evaluated the therapeutic response by CT scan, which showed partial response according to RECIST v 1.1. Due to significant nephrotoxicity, the treatment was discontinued after the 6th cycle and a follow-up after three months was recommended.
The rarity of this case made the diagnosis process challenging, but an accurate diagnosis was possible with the multidisciplinary team`s involvement. The treatment was initiated according to the international guidelines concerning extrapulmonary poorly differentiated neuroendocrine carcinomas/ large or small cell carcinomas. Although the evaluation showed partial response, small cell neuroendocrine carcinoma of the prostate is an aggressive tumor with a poor prognosis.