A Case of Rapidly Progressive De Novo Metastatic Small‐Cell Neuroendocrine Prostate Cancer

• Published in: Case reports in oncological medicine Vol. 2024; no. 1; p. 7998149
• Main Authors: Dalal, Aryan, Clark-Garvey, Sean, Gdowski, Andrew, Zhang, Sophia, Wobker, Sara E., Rowe, Steven P., Altun, Ersan, Beltran, Himisha, Milowsky, Matthew I.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 2024; Wiley
• Subjects: Abdomen; Androgens; Antigens; Back pain; Biopsy; Cancer; Cancer therapies; Care and treatment; Case Report; Chemotherapy; Development and progression; DNA methylation; Fractures; Gastrointestinal diseases; Histology; Hypertension; Intestinal obstruction; Liver; Liver cancer; Metastasis; Patients; Pelvis; Prostate cancer; Tomography; case report; prostate cancer; treatment of neuroendocrine prostate cancer; small-cell/neuroendocrine carcinoma
• ISSN: 2090-6706; 2090-6714
• DOI: 10.1155/2024/7998149

Introduction: Neuroendocrine/small‐cell prostate cancer (NEPC) is a rare and aggressive subtype of prostate cancer, which typically develops after prolonged treatment for metastatic castration‐resistant disease, but can, less commonly, occur de novo. Case Presentation: We describe a case of de novo NEPC in a tumor with mixed pathology including acinar adenocarcinoma and neuroendocrine/small‐cell carcinoma with rapid progression of metastatic disease. Despite initiation of treatment with androgen deprivation therapy (ADT) and chemotherapy, the patient continued to exhibit progression leading to multiple complications including a large bowel obstruction and ultimately progressive hepatic metastases resulting in liver failure. Conclusion: This case illustrates the clinical presentation and highly aggressive nature of de novo NEPC. Recognizing atypical clinical progression in prostate cancer is critical for the detection of NEPC; however, despite early identification and initiation of treatment, the prognosis remains poor, thus highlighting the need for further study into NEPC biology and novel therapeutic approaches.