MAB療法中に膀胱浸潤を認めた前立腺小細胞癌

Small cell carcinoma of the prostate diagnosed with the bladder invasion that appeared during maximum androgen blockade therapy

症例は72歳男性。PSA 79.4ng/ml，中分化型腺癌Gleason score 4＋5，T1cN0M0，stageB0に対しmaximum androgen blockade（MAB）療法を施行。prostate specific antigen（PSA）は1～2ng/mlで安定していたが，治療開始から1年10か月後に肉眼的血尿が出現。膀胱鏡にて膀胱浸潤を認め，生検で小細胞癌の診断。PSA 1.552ng/ml，NSE 220ng/ml（0～10ng/ml）。EP療法を8コース施行し8か月間PRを維持して治療継続中である。

A 72-year-old man treated with maximum androgen blockade therapy for a moderately differentiated prostate adenocarcinoma〔T1cN0M0,stageB0,prostate specific antigen（PSA）79.417 ng/ml,Gleason score 4＋5〕developed gross hematuria 1 year and 10 months after the beginning of the treatment. His serum PSA levels remained stable（1～2 ng/ml）. Cystoscopy disclosed the bladder invasion and histologically diagnosed as small cell carcinoma. PSA was 1.552 ng/ml,and neuro-specific enolase（NSE）was 220 ng/ml（0～10 ng/ml）. He received 8 courses of chemotherapy consisting of etoposide and cisplatin（EP）which has achieved partial remission of the bladder tumor.