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Kitajima K, Yamamoto S, Ikeda M, Yamasaki T, Kawanaka Y, Komoto H, Maruyama M, Nishizaki K, Kimura K, Kimura N, Yamakado K. Pelvic MRI, FDG-PET/CT, and Somatostatin Receptor Scintigraphy Findings of Treatment-Related Neuroendocrine-Differentiated Prostate Cancer. Case Rep Oncol 2021; 14:397-402. [PMID: 33776735 PMCID: PMC7983583 DOI: 10.1159/000511070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/22/2020] [Indexed: 11/19/2022] Open
Abstract
Treatment-related neuroendocrine-differentiated prostate cancer (NEPC) is a rare tumor entity that transdifferentiates from adenocarcinoma as an adaptive response to androgen receptor pathway inhibition. We report a 79-year-old male with treatment-related NEPC, presenting as rectal bleeding after hormonal therapy. MRI showed a 51 × 52 × 65 mm tumor occupying almost the whole prostate gland and invading the seminal vesicle and rectum as moderately heterogeneous hypointensity on T2-weighted image, restricted diffusion on apparent diffusion coefficient map and diffusion-weighted imaging, and heterogeneous enhancement on Gd-enhanced T1-weighted image. FDG-PET/CT showed strong FDG uptake of the prostate tumor, and somatostatin receptor scintigraphy (SRS) showed mild uptake of the prostate tumor. The surgically resected specimen revealed NEPC. If prostate cancer worsens despite conventional therapy, treatment-related NEPC should be considered, and the benefit of imaging examinations including prostate MRI, FDG-PET/CT, and SRS is in localizing lesions with neuroendocrine differentiation.
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Affiliation(s)
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine, Hyogo, Japan
| | - Masataka Ikeda
- Division Lower GI, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Yamasaki
- Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan
| | - Yusuke Kawanaka
- Department of Radiology, Hyogo College of Medicine, Hyogo, Japan
| | - Hisashi Komoto
- Department of Radiology, Hyogo College of Medicine, Hyogo, Japan
| | | | | | - Kei Kimura
- Division Lower GI, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Neinei Kimura
- Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan
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