前立腺小細胞癌の1例

SMALL CELL CARCINOMA OF THE PROSTATE : A CASE REPORT

　前立腺小細胞癌はきわめて稀な腫瘍であり，本邦ではこれまで9例報告がある。今回1例を経験した。多発性骨転移による背部痛，左下肢しびれを主訴とする77歳男性。前立腺は石様硬で前立腺腫瘍マーカーの上昇。針生検にて腺癌も否定できず，精巣摘除術を施行。腫瘍マーカーは低下したが，初診から約1か月で死亡。剖検にて前立腺は一部に腺癌を含む小細胞癌で占められていた。肝，膵，脊椎，肋骨などに小細胞癌の転移巣があった。

The patient was a 77-year-old man who presented with back pain and numbness. Rectal examination revealed a stony-hard prostate. Multiple bone metastases with osteolytic changes were found. The serum prostatic specific antigen (PSA) and γ-seminoprotein (γ-SM) were elevated. Abdominal CT revealed multiple hepatic metastases. By a needle biopsy of the prostate, small cell carcinoma (SCC) was suspected, but poorly differentiated adenocarcinoma could not completely be ruled out only by HE staining. Though PSA and γ-SM was decreased after hormonal therapy, he died 1 month after his first visit to out clinic.