[Prostatic neuroendocrine carcinoma with priapism : a case report]

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• A case study of an 84-year-old male with a history of stage C prostate cancer treated with hormonal therapy.
• The patient presented with priapism, a persistent penile erection, in May 2009.

Observation:

• Serum prostate-specific antigen (PSA) levels were within the normal range (0.02 ng/ml).
• Surgical interventions, including penile caverno-dorsal vein shunt (Barry shunt) and caverno-spongiosum shunt (Quackels shunt), were performed to manage priapism.
• Post-operative computed tomography (CT) indicated an enlarged prostate with multiple lung and bone metastases.

Findings:

• Histological examination of a prostatic needle biopsy confirmed poorly differentiated neuroendocrine carcinoma of the prostate.
• This diagnosis was made despite prior hormonal therapy and normal PSA levels.

Implications:

• Highlights the potential for aggressive neuroendocrine prostate cancer to present atypically, even with normal PSA.
• Underscores the importance of thorough diagnostic evaluation in cases of priapism, regardless of prior cancer treatment or PSA status.
• Suggests that neuroendocrine prostate cancer may require different management strategies compared to conventional adenocarcinoma.