膀胱小细胞神经内分泌癌1例报告

膀胱小细胞神经内分泌癌（small cell neuroendocrine carcinoma of the bladder,SCNECB）是罕见的高度恶性肿瘤,自1981年CRAMER首先报道以来至今不足200例.我院2011年1月收治1例,现报告如下.     

前列腺神经内分泌癌1例

前列腺神经内分泌癌临床罕见，我院收治1例，报告如下。     

原发性胆囊小细胞神经内分泌癌1例报告

正1病例资料患者,男性,65岁,因"反复右上腹疼痛半月"入院。患者无明显诱因出现右上腹阵发性疼痛半个月,为阵发性绞痛,多于夜间发作,持续1～2小时后可自行缓解,无伴畏寒发热、黄疸、腹胀、恶心呕吐、呼吸困难等症状。行B超可见胆囊结石,结石大小约59 mm×15 mm。为求治疗,于2018年3月21日入院。既往史无特殊,个人史无特殊。入院查体:皮肤、巩膜无黄染,腹平软,右上腹压痛,无反跳痛,Murphy征(+),移动性浊音(-)。肿瘤标志物CA199:336.49 U/mL(正常值0～35 U/mL)、     

膀胱小细胞神经内分泌癌1例报告并文献复习

膀胱小细胞神经内分泌癌是一种比较罕见的膀胱非上皮细胞性肿瘤，2002年5月，Cuesta Alcala等收集文献报道152例。我院自1990年以来共收治膀胱肿瘤353例，其中仅1例病理检查诊断为膀胱小细胞神经内分泌癌。现结合文献复习报告如下。     

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。     

前列腺小细胞神经内分泌癌诊疗特点分析

目的:探讨前列腺小细胞神经内分泌癌(SCPCa)的临床表现、病理特点及治疗进展.方法:报告SCPCa患者1例,并收集国内已报道57例SCPCa患者资料进行综合分析.结果:52例(91.2％)患者伴有尿路症状,其中尿路梗阻症状患者40例,53例(93.0％)患者前列腺触及明显异常结节,17例(29.8％)患者PSA＞4 ...     

前列腺小细胞癌诊疗研究进展

前列腺小细胞癌(SCC)是前列腺癌的一种罕见的变体,也是最具侵袭性的恶性肿瘤之一.尽管有新一代AR途径抑制剂(阿比特龙、恩杂鲁胺)来治疗去势抵抗性前列腺癌,然而随着疾病进一步发展为神经内分泌性前列腺癌(NEPC)并严重影响患者预后,于是针对其最常见变体前列腺SCC的研究不断深入,但其发病机制及治疗手段等仍存在争议.本文...     

肾上腺小细胞神经内分泌癌1例报告

患者女性，21岁。因左腰腹部疼痛2周收入院，体格检查可在左上腹部触及包块，边界清楚，压痛明显，无反跳痛。血常规示单核细胞占10．4％，红细胞为3．36×10^12／L，血小板为3．94×10^9／L。血沉为105．0mm／h。CT示L1-3椎体左前见有类圆形肿块，最大直径5．5cm。MR征象示左侧肾上腺区域可见一约4cm×5cm的类圆形占位性病变，其内部信号不均，T1W呈等低混杂信号，T2W呈等高混杂信号，病灶边界欠清楚。增强扫描，肿块呈明显的不均匀强化。左肾上极、胰腺明显受压。右侧肾上腺及右肾未见明显异常改变，后腹膜区未见异常信号影。人院后3d，局麻下行B超引导左肾上腺肿块穿刺活检，病理示左肾上腺神经内分泌癌。即在全麻下行左肾及左肾上腺全切术加后腹膜淋巴清扫。术中见患侧肾上腺肿瘤体积约11cm×4cm×3cm，切除后标本剖面肉眼观肿瘤呈鱼肉样，内有出血、坏死，整体切面呈灰白色。病理示组织面有中等大小圆或卵圆形瘤细胞，呈巢团状或弥散分布，浆少，核呈异型性，已侵犯周围脂肪组织伴坏死，未侵及同侧肾脏。免疫组化显示CD99（＋）、SYN（＋）、Vinmentin部分（＋）。病理证实为（左）肾上腺小细胞神经内分泌癌伴坏死。[第一段]     

前列腺小细胞神经内分泌癌患者一例报道并文献复习

目的探讨前列腺小细胞神经内分泌癌的临床诊断和治疗。 方法回顾性分析我院收治的1例前列腺小细胞神经内分泌癌患者的资料。结合相关文献讨论前列腺神经内分泌肿瘤的病理学分型、临床表现、影像学特征、诊治和预后。 结果患者男性,64岁,2014年9月因发现PSA 52.72 μg/L,前列腺穿刺活检提示前列腺腺泡腺癌,Gleason评分3+4=7分,予手术去势,后联合持续抗雄治疗（比卡鲁胺50 mg qd）。2017年5月复查发现盆腔巨大肿物伴肠梗阻,全身多发骨转移、肝脏转移、肺转移。予盆腔肿物切除+横结肠造瘘,术后病理提示前列腺小细胞内分泌癌。患者术后2周开始予多西他赛100 mg d1+卡铂450 mg d1,化疗2周期后因多脏器功能衰竭去世。 结论前列腺癌伴神经内分泌分化为最常见的前列腺神经内分泌肿瘤,前列腺小细胞癌临床罕见,早期手术联合化疗为主要治疗手段,肿瘤恶性程度高、进展快,预后差。     

Small cell neuroendocrine carcinoma of the ampulla of Vater with foci of squamous differentiation: a case report

A 54-year-old woman with obstructive jaundice was found to have a 4-cm ulcerated, elevated tumor, located at the papilla of Vater by endoscopy and radiographic investigation. Based on a clinical diagnosis of carcinoma of the ampulla of Vater, a pylorus-preserving pancreaticoduodenectomy was performed. The histologic appearance of the lesion was identical to extrapulmonary small cell carcinoma, with diffuse proliferation of small, spindle-shaped, atypical tumor cells with numerous mitoses. Neuroendocrine differentiation was demonstrated by immunoreactivity with neuron-specific enolase (NSE) and Leu-7, and by the presence of dense core granules ultrastructurally. The tumor was composed mainly of small cell neuroendocrine carcinoma, and partially of an area of squamous differentiation, showing transition from one to the other. Histopathologic investigation disclosed direct invasion deep to the lamina propria, and infiltration of the pancreatic parenchyma, duodenum, and bile duct. Lymph node metastases were present in the superior pancreaticoduodenal chain. The patient died of liver metastases 8 months later. As in previously reported cases of small cell neuroendocrine carcinoma of the ampullary region, the present case showed extremely aggressive clinical behavior with early metastases resulting in fatal outcome.     

前列腺小细胞神经内分泌癌诊治特点分析

目的 探讨前列腺小细胞神经内分泌癌(SCPCa)的临床特征和诊疗方法.方法 SCPCa患者4例,平均年龄62(25～77)岁.表现进行性排尿困难4例,慢性尿潴留2例,上尿路积水2例.直肠指检前列腺巨大、质硬包块;血tPSA 0.57～6.36 ng/ml,f/tPSA 0.26～0.63.B超、CT、MRI检查见前列腺区3.9 cm×3.9 cm× 1.6 cm～11.3 cm× 7.9 cm×9.5 cm肿块,形态不规则,侵犯精囊2例、直肠2例、单侧输尿管下端2例、骶骨1例,盆腔淋巴结转移3例、肝转移1例、肺转移1例;全身骨扫描示多处骨转移3例.结果 4例均经前列腺穿刺活检确诊,光镜下见癌细胞呈卵圆形或梭形,体积小、胞质少,界限欠清,核分裂相多见,染色质深染;免疫组化染色:ChA(+)4例、NSE(+)2例、PSA(-)4例.采用以顺铂为基础的化疗、放疗、化疗加放疗各1例,近期疗效较好,但分别于6、9、11个月出现全身广泛转移;放弃治疗1例;1年内死亡3例,失访1例.结论 SCPCa临床罕见,肿瘤恶性度高、生长快,发生转移早且严重,诊断依靠病理检查,综合治疗效果不佳,预后极差.     

肾原发性大细胞神经内分泌癌1例报告并文献复习

目的提高对肾神经内分泌癌的认识。方法报告1例肾原发性大细胞神经内分泌癌的临床资料并结合文献讨论有关临床症状、诊断和治疗。结果肾神经内分泌癌临床表现和影像学与常见。肾癌相比无明显特异性,需通过病理学和免疫组织化学结果肯定诊断。结论肾原发性大细胞神经内分泌癌罕见,其临床和影响学表现难与肾癌区别,主要靠病理学和免疫组织化学确诊,该病恶性程度高、预后差,只有早期发现,早期手术治疗以提高疗效。     

Case report: Subcutaneous metastasis from small cell carcinoma of the prostate

Pure primary small cell carcinoma of the prostate (SCCP) is an extremely rare entity. Natural history of this tumor is similar to that of the bronchogenic small cell carcinoma. Several theories of histogenesis have been proposed. Most widely accepted view is that SCCP arises from pluripotent stem cells of the prostate, which have the ability to differentiate into either epithelial or neuroendocrine type carcinomas. SCCP has an aggressive course, and a majority of patients have distant metastasis at presentation. Since it is a rare entity, no standard treatment regimen has been established. A case of primary pure SCCP with multiple subcutaneous metastases is presented.     

前列腺小细胞癌1例报告并文献复习

目的 提高前列腺小细胞癌的诊治水平.方法 报告前列腺小细胞癌1例,结合文献复习,进行回顾和分析.前列腺体积明显增大,质地硬,表面尚光滑,轻度触痛;B超、MRI提示盆腔巨大肿块,分叶状,质地不均匀,大小为9 cm×9 cm×10cm,压迫并突向膀胱和直肠腔,双侧肾盂积水.结果 前列腺穿刺活检,病理为小细胞癌,免疫组化提示PSA(-),CgA(-),Syn( ),CD56( );因无手术适应证,以及患者拒绝化疗,故施以内分泌治疗,其临床症状无缓解,排尿困难及双肾积水进行性加重,并出现不完全性肠梗阻,全身状况进行性恶化,3月后死于多系统器官功能衰竭.结论 前列腺小细胞癌须病理和免疫组化来确诊,其发病率低,恶性度极高,生长迅速,应与前列腺肉瘤鉴别.治疗以化疗为主,但缓解期短;对内分泌治疗不敏感,姑息性手术和局部放疗可以改善患者生存质量.     

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。     

An unusual case of primary small cell neuroendocrine carcinoma of the breast

Primary small cell neuroendocrine carcinoma of breast is a rare entity, with only case reports in literature. Histologically, these tumors are similar to small cell carcinoma of the lung with some evidence of ductal carcinoma-in-situ with areas of ductal, lobular, or papillary differentiation. Immunoreactivity for neuroendocrine markers is present in two thirds of cases, while 33-50% are positive for estrogen receptor or progesterone receptor. Her2/neu expression has not been reported in small cell carcinoma of the breast. Here we are presenting 53-year-old women with locally advanced primary small cell neuroendocrine carcinoma of breast. We will discuss clinicopathological findings, treatment options, prognosis and review of the literature on primary small cell carcinoma of breast.     

Poorly differentiated neuroendocrine carcinoma of the breast with Merkel cell features

Neuroendocrine carcinoma of the breast is a rare tumor subtype comprising less than 1% of breast cancers in the United States. Merkel cell features within this rare subtype are even rarer. We report a neuroendocrine breast carcinoma with Merkel cell features. The patient underwent breast conservation therapy and a sentinel lymph node biopsy. Unfortunately, the tumor was extremely aggressive and at 5 weeks postoperatively she presented with widely metastatic disease. Due to the aggressive nature of this tumor, we reviewed the literature and treatment options for this rare variant of a rare subtype.