Author(s) :

Madalina-Cristina, Mihaela.

Volume/Issue :

Abstract :

Poorly differentiated neuroendocrine carcinomas are very rare. Most of them arise from the lung, 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 large cell neuroendocrine carcinoma of the prostate with multiple metastases. He underwent 5 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. Because of important nephrotoxicity, the treatment was discontinued after the 6th cycle and follow-up after three months was recommended. The rarity of this case made the diagnosis process challenging, but was manageable with the involvement of the multidisciplinary team. 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, large cell neuroendocrine carcinoma of the prostate is an aggressive tumor with a poor prognosis.

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