前立腺小細胞癌の1剖検例

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83歳男性.患者は排尿困難,背部痛を主訴とした.Prostate specific antigen(PSA)の上昇を認め,前立腺エコーにて前立腺癌と診断し,LH-RHアナログ投与を開始したところ,PSAは低下したが,背部痛が高度となり,精査加療目的で入院となった.入院時,PSAの上昇はみられず,肝機能が急速に悪化し,肝不全にて死亡した.病理解剖の結果,前立腺原発小細胞癌と診断され,肝,腰椎,肺には転移を認めたが,リンパ節転移はみられなかったAn 83-year-old man was admitted to our hospital with complaints of dysuria and backache. The patient had been treated with a luteinizing hormone-releasing hormone analogue for 2 years. An enlarged, hard and nodular prostate was palpable on digital rectal examination. Serum level of prostate specific antigen (PSA) was 1.7 ng/ml (0-4) and that of neuron-specific enolase (NSE) were 263.2 ng/ml (0-10). Multiple bone and liver metastases were seen on CT and MRI. After hospitalization, the liver function worsened markedly. The patient died on the 34th hospital day, and was diagnosed with primary small cell carcinoma of prostate on autopsy.
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