Urethral Metastasis of Therapy-Induced Neuroendocrine Prostate Cancer Successfully Managed With Chemoradiotherapy: A Case Report

IF 0.5 Q4 Medicine

IJU Case Reports Pub Date : 2026-08-07 DOI:10.1002/iju5.70234

Toshiaki Kayaba, Satoshi Washino, Takanori Hayase, Kai Yazaki, Kimitoshi Saito, Tomoaki Miyagawa

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Abstract

Introduction

Urethral metastasis of prostate cancer is exceptionally rare, particularly in castration-resistant disease. Therapy-induced neuroendocrine prostate cancer (t-NEPC) is an aggressive variant with limited treatment options.

Case Presentation

A 72-year-old man, 14 years after diagnosis of prostate adenocarcinoma treated with androgen deprivation therapy, presented with hematuria and dysuria. Prostate-specific antigen was 2.05 ng/mL and neuron-specific enolase was 28.0 ng/mL. Urethroscopy revealed papillary tumors in the pendulous urethra. Histology showed high-grade adenocarcinoma with a small cell carcinoma component, positive for synaptophysin and prostate-specific antigen. Genomic profiling demonstrated PTEN loss, TP53 mutation, and androgen receptor amplification. Platinum-based chemotherapy with external-beam radiotherapy achieved durable urethral local control despite later distant progression; the patient survived 2 years 10 months.

Conclusion

Platinum-based chemoradiotherapy may provide durable local control of urethral metastasis from t-NEPC.

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放化疗成功治疗治疗性前列腺神经内分泌癌尿道转移1例。

前列腺癌的尿道转移是非常罕见的，特别是在去势抵抗疾病。治疗性神经内分泌前列腺癌（t-NEPC）是一种治疗选择有限的侵袭性前列腺癌。病例介绍：一名72岁男性，在诊断前列腺癌14年后接受雄激素剥夺治疗，出现血尿和排尿困难。前列腺特异性抗原2.05 ng/mL，神经元特异性烯醇化酶28.0 ng/mL。尿道镜检查显示下垂尿道乳头状肿瘤。组织学显示高级别腺癌伴小细胞癌成分，突触素和前列腺特异性抗原阳性。基因组分析显示PTEN缺失，TP53突变和雄激素受体扩增。铂基化疗联合外束放疗实现了持久的尿道局部控制，尽管后来出现了远处进展；患者存活2年10个月。结论：铂基放化疗可持久局部控制t-NEPC尿道转移。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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