[Neuroendocrine carcinoma of the prostate effectively treated by cisplatin and irinotecan--a case report]

A 79-year-old man was referred to our hospital with urinary retention in August 2004. Because the serum PSA was 2,9 39 ng/mL,we performed transabdominal prostatic needle biopsy. Pathological examination of the prostate revealed conventional adenocarcinoma. CT scans and MRI showed a huge mass and lymph node metastasis. He was treated with diethyl stilbestrol diphosphate,followed by maximal androgen blockade therapy,and the serum PSA level decreased favorably. Follow-up CT revealed prostate and lymph node metastasis were reduced, but liver metastases, measuring 45 x 34 mm and 28 x 24 mm, respectively, were newly recognized in February 2006. The NSE level was high at 88.5 ng/mL, so a percutaneous liver biopsy was performed,and pathological examination of the liver revealed metastatic prostate cancer which showed neuroendocrine differentiation. The treatment was changed to chemotherapy comprising cisplatin and irinotecan. After three courses of the chemotherapy,liver metastasis was reduced in CT scans.