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Case Reports
. 2017 Sep-Oct;22(5):349-353.
doi: 10.1016/j.rpor.2017.06.003. Epub 2017 Jul 22.

Intensity-modulated radiation therapy for small cell carcinoma of the prostate: A case report

Yaichiro Hashimoto  1 , Yuka Ishii  1 , Sawa Kono  1 , Sachiko Izumi  1 , Junpei Iizuka  2 , Atsuko Hiroi  3 , Kumiko Karasawa  1
Affiliations
Case Reports

Intensity-modulated radiation therapy for small cell carcinoma of the prostate: A case report

Yaichiro Hashimoto et al. Rep Pract Oncol Radiother. 2017 Sep-Oct.

Abstract

Small cell carcinomas (SCC) make up only 1% of malignancies of the prostate. Reports of several case series have described outcomes of surgery and chemotherapy for SCC of the prostate, but few reports address radiotherapy. We treated a case of SCC of the prostate with intensity-modulated radiation therapy (IMRT) consisting of 70 Gy administered in 35 fractions followed by hormonal therapy using only luteinizing hormone-releasing hormone (LH-RH) agonist. The tumor volume decreased remarkably by 4 months after IMRT. The rapid decrease in tumor size of this SCC of the prostate seemed to suggest a similar high radiosensitivity to that of SCC of the lung, but the tumor increased rapidly thereafter within the radiation fields, and pelvic lymph node metastases had developed by 24 months after IMRT. By 28 months after IMRT, multiple lung metastases developed, and the patient died of SCC of the prostate 31 months after initial diagnosis.

Keywords: IMRT; Prostate cancer; Radiotherapy; Small cell carcinoma.

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Figures

Fig. 1
Fig. 1
Magnetic resonance imaging demonstrates a large mass in the right lobe of the prostate that invades beyond the surgical capsula of the prostate and to the right seminal vesicle. (A) Iso-signal intensity on T1-weighted image; (B) low signal intensity on T2-weighted image; (C) high signal intensity on diffusion-weighted image.
Fig. 2
Fig. 2
Pathological findings of the biopsy specimen. (A) Hematoxylin and eosin (H&E) staining, 400×. Tumor cells are small and indicate solid alveolar growth and central necrosis. No adenocarcinoma component is seen. (B) Strong positive staining for chromogranin A, 400×; (C) strong positive staining for MIB1 index, 400×.
Fig. 3
Fig. 3
Dose distribution of intensity-modulated radiation therapy. Planning target volume, pink color wash. Number at left indicates the percentage of the prescribed radiation dose.
Fig. 4
Fig. 4
Contrast-enhanced computed tomography 4 months after intensity-modulated radiation therapy shows remarkable shrinkage of the tumor volume.
Fig. 5
Fig. 5
Contrast-enhanced computed tomography reveals rapid recurrence of the tumor within the radiation fields and development of pelvic lymph node metastases 24 months after intensity-modulated radiation therapy.
See this image and copyright information in PMC

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