前列腺小细胞癌1例报告并文献复习

<正>前列腺小细胞癌(small cell carcinoma of the prostate,SCCP)是一种临床比较少见的恶性肿瘤,分化差,恶性程度高,生长快速,极易发生浸润和转移,预后很差。前列腺小细胞癌发病率很低,在所有前列腺癌中所占比例1%[1]。1977年Wenk等[2]首次报道了前列腺小细胞癌,之后国内外陆续有个案报道,但总体例数不多,且多数病例为前列腺小细胞癌混合前列腺腺癌,少见完全性前列腺小细胞癌     

前列腺小细胞癌诊治特点分析(附2例报告并文献复习)

小细胞癌多发生在肺部,肺外较罕见,原发于前列腺的小细胞癌罕见,肿瘤分化低、易转移,无有效治疗手段,预后极差[1].2006年至2010年我院收治2例,现报道如下.     

前列腺小细胞癌二例报告

小细胞癌多发生在肺部 ,肺外较罕见 ,前列腺小细胞癌至今文献报道仅 6 0余例。我们收治 2例 ,报道如下。例 1,男 ,5 5岁。尿频、夜尿增多 1年。诊为轻度前列腺增生 ,未予治疗 ,近3个月症状加重 ,排尿困难并急性尿潴留就诊。查体 :前列腺Ⅲ°增生 ,质地中等偏硬 ,表面光滑 ,未扪及结节。血ＰＳＡ正常 ,胸片无异常 ,诊为前列腺增生行前列腺摘除术 ,术中发现前列腺明显增大并突向膀胱 ,剜除前列腺时发现前列腺与外科包膜粘连。术后病理示前列腺小细胞癌 ,予双睾切除、氟他胺、抑那通治疗 ,因全身广泛转移 3个月后死亡。例 2 ,男 ,34岁。排尿淋…     

前列腺小细胞癌诊疗体会(附2例报告)

目的:探讨前列腺小细胞癌的临床表现、诊断方法、病理特征及治疗方法,以期提高对前列腺小细胞癌的进一步认识。方法:回顾性分析2017年11月至2018年3月收治的2例确诊前列腺小细胞癌的临床及病理资料,并复习相关文献。结果:2例患者均有排尿困难症状,PSA均有升高,前列腺触诊有II°～III°增大,其中1例行前列腺穿刺活检,1例行经尿道前列腺部肿瘤1470激光汽化切除术。术后病理均提示前列腺腺癌伴前列腺小细胞癌,1例患者行EP方案化疗,于确诊20个月后死于全身多器官功能衰竭;1例患者行内分泌治疗,目前带瘤存活。结论:前列腺小细胞癌发病率低,恶性程度高。确诊后平均生存期约7～10个月,目前仍无可靠治疗方案,现基本参照肺小细胞癌的治疗经验,仍以化疗为主,该病预后较差,治疗效果多不满意。     

前列腺小细胞癌1例

<正>1病例报告患者男,84岁,因"前列腺增生手术后排尿困难6个月,加重伴血尿1周"至我院泌尿外科就诊。既往有高血压、脑梗塞病史。10年前因前列腺增生行经耻骨上前列腺剜除术,术后病理示:前列腺结节性增生,部分组织低级别前列腺上皮内瘤((prostatic intraepithelial neoplasm,PIN)。手术后排尿功能恢复可,门诊随访偶有尿频,予托特罗定4mg口服,1次/d,复查PSA4ng/mL。本次门诊予多沙唑嗪4mg口服,1     

前列腺移行细胞癌(附2例报告)

目的;提高前列腺移行细胞癌的诊治水平。方法：回顾分析2例前列腺移行细胞癌患者临床资料,结合文献复习讨论。结果：1例行前列腺癌根治术,术后予吡柔比星膀胱灌注化疗,现仍在随访中,另1例行经尿道前列腺切除术加经尿道电气化术,术后半年死亡。结论：本病多以肉眼血尿就诊。确诊主要依赖前列腺穿刺活检及术后病理检查。治疗以手术加膀胱灌注化疗为主,预后较其他前列腺癌差。     

前列腺移行细胞癌的临床分析(附4例报告)

<正>前列腺移行细胞癌(transitional cell carcinoma,TCC)是临床少见的泌尿系统恶性肿瘤,不易诊治,且转移快、预后差。本院从2005年12月至2010年6月共收治前列腺TCC患者4例,现结合文献就其临床资料进行系统回顾,以利于提高该病的诊治水平。     

前列腺小细胞癌长期生存1例

<正>患者,男,70岁。因"排尿困难伴无大便10余天"于2007年7月6日入院。直肠指诊前列腺Ⅲ度增大,不光滑,中央沟消失,上方可扪及巨大肿块,向肠腔突出,质地硬,移动度差,指套未见明显染血。检查PSA为15.67ng/ml;生化电解质检查:肌酐807μmol/L,尿素22.9mmol/L,钾4.2mmol/L,钠136mmol/L,余正常;血常规检查:血红蛋白107g/L,白细胞3.8×109/L,中性80%。     

前列腺小细胞癌二例报告并文献复习

目的探讨前列腺小细胞癌的临床、病理特征及治疗方法。方法总结2例前列腺小细胞癌患者的临床资料并进行文献复习。例1,50岁,因排尿困难伴会阴部疼痛3个月入院。直肠指检前列腺Ⅲ度(5．0 cm×6．0 cm)增生,质硬,表面欠光滑。血清PSA 0．31 ng／ml,fPSA 0．09ng／ml。B超示低回声块,CT示前列腺密度不均。经直肠穿刺活检示前列腺癌,行前列腺癌根治术。例2,82岁,因排尿困难伴间歇性血尿4个月入院。直肠指检前列腺Ⅱ度(4．0 cm×5．0 cm)增生,质硬伴多发性结节,表面欠光滑。血清PSA 2．61 ng／ml,fPSA 0．05ng／ml。B超示低回声块,CT示前列腺密度不均,精囊及膀胱颈部受侵犯。经直肠穿刺活检示前列腺小细胞癌,行双睾切除术加TURP。结果2例术后病理均诊断为前列腺小细胞癌。肿瘤呈弥漫性片巢状结构,伴大片凝固性坏死,核小、燕麦状或圆形、染色深、核仁不明显、胞质少,类似肺小细胞癌。精囊及膀胱颈部均有肿瘤细胞浸润。免疫组化染色检查:LCA、L-26、34βE12(-),PSA、AE1／AE3、AR(+),CA、S-100(±)。例1术后1个月死于广泛肺转移,例2术后3个月发现后腹膜转移,仍在随访中。结论前列腺小细胞癌少见,确诊依靠临床及病理表现。对早期前列腺小细胞癌,根治性前列腺癌切除术加激素及化疗是可行的,晚期患者则无较满意的治疗方法,且预后差。     

氩氦刀治疗前列腺小细胞癌4例分析并文献复习

目的 探讨氩氦刀治疗前列腺小细胞癌的有效性,提高对该疾病的认知水平.方法 回顾性分析航天中心医院泌尿外科2013年至2018年收集的4例经氩氦刀治疗的前列腺小细胞癌患者的诊疗及随访过程,并结合文献进行归纳总结.结果 4例患者中,1例体检发现前列腺特异性抗原(PSA)升高,其余3例表现为渐进性排尿困难.所有病例经病理及免...     

肾上腺小细胞神经内分泌癌1例报告并文献复习

目的：探讨肾上腺小细胞神经内分泌癌的起源、诊断要点和治疗方法,以提高对该病的认识。方法：回顾性分析我院收治的一例肾上腺小细胞神经内分泌癌患者,结合国内外文献对本病进行复习总结。结果：本病起源于神经内分泌细胞,临床表现不典型,免疫组化NSE、CgA和Syn可呈阳性,诊断前需排除转移癌,早期发现并手术治疗可能收到良好效果。结论：肾上腺小细胞神经内分泌癌是一种罕见的高度恶性肿瘤,临床表现缺乏特异性,组织学特点和免疫组化神经内分泌标志物是诊断的主要依据,需与肾上腺转移癌相鉴别。可借鉴肺小细胞癌的治疗模式,早期诊断治疗可能是提高其疗效的关键。     

膀胱小细胞神经内分泌癌1例报告并文献复习

目的：探讨膀胱小细胞神经内分泌癌的病理及临床特征,提高对该病的认识和诊洽水平。方法：介绍1例94岁高龄膀胱小细胞神经内分泌癌患者的诊治情况及病理特点,并复习有关文献,分析该肿瘤的组织来源、病理和免疫组化特征、诊治及预后情况。结果：本例行经尿道膀胱肿瘤电切术,术后病理诊断为小细胞神经内分泌癌。免疫组化染色示肿瘤细胞表达神经内分泌标记物NSE和CgA,肿瘤标志物Ki-67、C-erB-2、P53表达阳性,PSA、Syn表达阴性。患者术后1个月死亡。结论：膀胱小细胞神经内分泌癌是一种比较少见的高度恶性肿瘤,主要依靠病理及免疫组化诊断,早期膀胱镜检查及活检有助于诊断。     

Small Cell Carcinoma of the Prostate: A Case Report

A case of small cell carcinoma of the prostate without a primary lesion in the lung was reported. The cancer was diagnosed after the patient complained of lumbago caused by bone metastasis. The tumor was 5.9 times 5.0 times 4.6cm. The patient was treated with 4 courses of chemotherapy using cisplatin and etoposide. The tumor diminished to 4.0 times 4.0 times 3.5 cm after completion of the 4 courses of treatment. Prostatic antigen levels were less than 1.0ng/mL during the therapy. Neuron-specific enolase levels were 35.9ng/mL at the beginning of therapy, and decreased to 7.4 ng/mL after completion of 4 courses of treatment. The patient died 3 months after the completion of treatment. This regimen had some value for inhibiting the growth of small cell carcinoma.     

Small Cell Carcinoma of the Bladder: A Case Report and Review of the Literature

Primary pure small cell neuroendocrine carcinoma of the bladder is a rare condition. It is an aggressive tumor with an average five-year survival rate of less than 10% as cited by multiple case reports. We report a 48 year-old male patient with primary small cell neuroendocrine carcinoma of the bladder who was treated with TUR-T, adjuvant carboplatin-based chemotherapy and radiotherapy. The patient is free of disease at the end of 30 months with a normally functioning bladder.     

Small Cell Carcinoma of the Kidney: Case Report

An 83-year-old female diagnosed with small cell carcinoma of the kidney is reported on. The clinical picture was similar to that seen with transitional cell carcinoma of the renal pelvis. A right nephroureterectomy was performed and a histological examination revealed similar morphological features to those of small cell carcinoma of the lung. Neuroendocrine differentiation was proven by a positive immunoreaction to neuron-specific enoiase. A review of the literature indicated that in the urinary tract, most of the cases of small cell carcinoma occurred in the urinary bladder, with this case being the eleventh reported case of small cell carcinoma originating in the kidney. As with many of the other cases of small cell carcinoma of the urinary tract, this patient's tumor was associated with both adenomatous and squamous differentiation. The patient died 2 months after surgery, prior to any chemotherapy administration.     

Merkel Cell Carcinoma of the Foot: Case Report and Review of the Literature

Merkel cell carcinomas are rare neuroendocrine tumors of the skin with highly malignant behavior. These tumors arise from Merkel cells, which are slowly adapting type 1 mechanoreceptors that occur in hair follicles and the basal layer of the epidermis. Merkel cell carcinomas are typically located in the dermis and frequently extend into the subcutaneous fat and lymphatics. This case report describes the magnetic resonance imaging and pathologic findings, surgical treatment, and postoperative results with review of the literature for Merkel cell carcinoma involving the foot of a 72-year-old man with a 2-month history of a painless, enlarging mass that interfered with his ability to wear a shoe.     

雄激素阻断治疗后前列腺腺癌转化为小细胞癌1例报告并文献复习

目的：探讨前列腺小细胞癌的临床、病理特征及诊治方法．方法：分析1例前列腺小细胞癌患者的临床资料：患者男．54岁。因“尿频、尿急、排尿困难1个月”入院。直肠指诊前列腺Ⅲ。大．质硬,表面不光滑。血PSA为175．08ng／ml。B超及MRI检查均提示前列腺癌．前列腺穿刺活检诊断为前列腺腺癌．行最大限度雄激素阻断治疗。9个月后症状加重,复查血PSA为7．4mg／ml。MRI提示前列腺腺癌,行前列腺电切术,病理检查为前列腺小细胞癌。免疫组织化学示CD56（＋）,NSE（＋）,CgA（-）．LCA（-）。遂以GP方案化疗：吉西他滨1800mg,DDP150mg,采用4周方案,一共行4个疗程。从第2个疗程开始同步局部放疗（3D-CRT。每次3Gy,总量60Gy）。结果：复查CT前列腺局部肿瘤消失,排尿通畅,但在随访的过程中。患者死于急性心肌梗死。结论：雄激素阻断治疗后,前列腺腺癌可能转化为小细胞癌,前列腺小细胞癌少见,恶性程度高,确诊需依靠临床及病理表现。强调早发现,早治疗。治疗以化疗为主,可辅以放疗,早期前列腺小细胞癌,也可行前列腺癌根治加化疗。     

原发性膀胱印戒细胞癌1例报告并文献复习

目的：探讨原发性膀胱印戒细胞癌的临床特征。方法：报告1例原发性膀胱印戒细胞癌患者的临床资料。患者因间歇性肉眼血尿就诊,术前检查未找到任何膀胱外病灶,行膀胱全切除术＋输尿管造瘘术。结果：术后病检报告为膀胱印戒细胞癌。患者术后转肿瘤科化疗,目前正在随访中。结论：原发性膀胱SRCC非常罕见,进展快、恶性程度高,局部浸润性生长,有早期扩散转移倾向,预后差。其确诊主要依靠病理组织学检查。     

Signet-Ring Cell Carcinoma of the Ileum: Report of a Case and Review of the Japanese Literature

(Received for publication on Nov. 14, 1996; accepted on Nov. 6, 1997)     

膀胱原发性印戒细胞癌伴发前列腺腺癌1例报告及文献复习

目的:探讨膀胱原发性印戒细胞癌(primary signet ring cell carcinoma of the bladder.PSRCC)伴前列腺癌的临床特征及诊治方法。方法:总结1例膀胱PSRCC伴前列腺癌患者的资料,检索Pubmed、CBM数据库相关文献并复习。结果:膀胱镜检病理示膀胱印戒细胞癌。血PS A:12.73 ng/ml,FPSA:0.737 ng/ml,FPSA/PSA:0.06。前列腺穿刺活检示前列腺腺癌,Gleason评分3+3。行经尿道膀胱肿瘤切除术(TURBT)术和最大限度雄激素阻断治疗,术后1 6个月膀胱癌复发。结论:膀胱PSRCC临床少见,浸润性强,进展快,诊断主要依靠病理和免疫组织化学检查,对于膀胱PSRCC伴发前列腺癌首选根治性膀胱前列腺切除术治疗,预后差。