Multiple Spinal and Bone Metastases as the Initial Presentation of Small Cell Carcinoma of the Prostate

前列腺小細胞癌在臨床上罕見且不易早期診斷，過去統計上的發生率占前列腺癌約1%，其病理特點為細胞較小，分化較低，PSA可陰性，且多種神經內分泌標記物可陽性，例如: chromogranin A及synaptophysin。其臨床症狀常以泌尿道排尿阻塞症狀表現，而實驗室檢查較難有早期協助診斷的工具，臨床上常用的PSA可不升高。而因為發病年齡較輕，故易誤診為慢性前列腺炎或前列腺肥大。而治療上早期以手術為主，但因不易早期發現，故病人多只能接受化學治療併放射治療作疾病控制及症狀緩解，亦為治療效果不彰的原因之一，我們在此提出一位前列腺小細胞癌的病例，病人臨床上以背痛及肢體麻表現而無泌尿道相關症狀，在疾病初期亦不易確定診斷，之後接受化放療後，疾病控制約十個月。藉由此個案提供臨床醫師相關治療經驗，並希望在未來能對此族群有更大規模的研究及治療策略以改善治療成效。

關鍵字

小細胞癌；前列腺；脊椎轉移

並列摘要

Small cell carcinoma (SmCC) of the prostate is a very rare and aggressive type of prostatic cancer. It is hard to early diagnose and most cases are diagnosed at advanced stage. The bones, liver, regional and distant lymph nodes are the most common sites of metastasis. The treatment for SmCC of the prostate is different from that of acinar adenocarcinoma. While chemotherapy is suggested, there is no standard regimen, let alone personalized strategy. Additionally, hormone therapy does not often work for this type of prostate cancer. Here, we report a rare case of SmCC of the prostate who initially presented with lower cervical spine radiculopathy.

並列關鍵字

small cell carcinoma ； prostate ； spinal metastasis

國際替代計量

Multiple Spinal and Bone Metastases as the Initial Presentation of Small Cell Carcinoma of the Prostate

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