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目的提高前列腺小细胞癌的诊治水平。方法报告前列腺小细胞癌1例,结合文献复习,进行回顾和分析。前列腺体积明显增大,质地硬,表面尚光滑,轻度触痛;B超、MRI提示盆腔巨大肿块,分叶状,质地不均匀,大小为9cm×9cm×10cm,压迫并突向膀胱和直肠腔,双侧肾盂积水。结果前列腺穿刺活检,病理为小细胞癌,免疫组化提示PSA(-),CgA(-),Syn(+),CD56(+);因无手术适应证,以及患者拒绝化疗,故施以内分泌治疗,其临床症状无缓解,排尿困难及双肾积水进行性加重,并出现不完全性肠梗阻,全身状况进行性恶化,3月后死于多系统器官功能衰竭。结论前列腺小细胞癌须病理和免疫组化来确诊,其发病率低,恶性度极高,生长迅速,应与前列腺肉瘤鉴别。治疗以化疗为主,但缓解期短;对内分泌治疗不敏感,姑息性手术和局部放疗可以改善患者生存质量。
Objective To improve the diagnosis and treatment of prostatic small cell carcinoma. Methods Report of 1 case of small cell carcinoma of the prostate, review and review of the literature for review and analysis. Prostate volume increased significantly, the texture is hard, the surface is still smooth, mild tenderness; B ultrasound, MRI showed pelvic mass, lobulated, uneven texture size of 9cm × 9cm × 10cm, oppression and sudden bladder and rectum Cavity, bilateral hydronephrosis. Results Prostate biopsy showed that the pathology was small cell carcinoma. Immunohistochemistry showed that PSA (-), CgA (-), Syn (+) and CD56 (+) were not detected. Treatment, the clinical symptoms without remission, dysuria and hydronephrosis with progressive aggravated, and incomplete intestinal obstruction, general condition deteriorated, died of multiple system organ failure in March. Conclusions Prostatic small cell carcinoma should be diagnosed by pathology and immunohistochemistry. Its incidence is low, its malignancy is very high and its growth is rapid. It should be differentiated from prostatic sarcoma. Chemotherapy-based treatment, but the short response time; insensitive to endocrine therapy, palliative surgery and local radiotherapy can improve the quality of life of patients.