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Updated: Aug 9, 2026
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Published on: March 6, 2018
Urethral Metastasis of Therapy-Induced Neuroendocrine Prostate Cancer Successfully Managed With Chemoradiotherapy: A
Toshiaki Kayaba1, Satoshi Washino1, Takanori Hayase1
1Department of Urology Jichi Medical University Saitama Medical Center Saitama Saitama Japan.
Introduction:
Urethral metastasis of prostate cancer is exceptionally rare, particularly in castration-resistant disease. Therapy-induced neuroendocrine prostate cancer (t-NEPC) is an aggressive variant with limited treatment options.
Case Presentation:
A 72-year-old man, 14 years after diagnosis of prostate adenocarcinoma treated with androgen deprivation therapy, presented with hematuria and dysuria. Prostate-specific antigen was 2.05 ng/mL and neuron-specific enolase was 28.0 ng/mL. Urethroscopy revealed papillary tumors in the pendulous urethra. Histology showed high-grade adenocarcinoma with a small cell carcinoma component, positive for synaptophysin and prostate-specific antigen. Genomic profiling demonstrated PTEN loss, TP53 mutation, and androgen receptor amplification. Platinum-based chemotherapy with external-beam radiotherapy achieved durable urethral local control despite later distant progression; the patient survived 2 years 10 months.
Conclusion:
Platinum-based chemoradiotherapy may provide durable local control of urethral metastasis from t-NEPC.