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目的提高对前列腺小细胞神经内分泌癌的认识。方法报告1例86岁高龄前列腺小细胞神经内分泌癌患者,有血尿伴排尿困难症状,肛指检查示前列腺增生,质地中等,前列腺特异性抗原(PSA)正常,为0.867ng/m L,B超示:双肾积水,双侧输尿管全程扩张,膀胱内较多血块,前列腺增生。结合文献分析发病情况、发病机制、临床特征、诊断、治疗及预后。结果全身麻醉下行经尿道膀胱泵洗及经尿道前列腺电切术。前列腺电切病理结果显示小细胞神经内分泌癌。术后CT疑胰腺有转移病灶,9d后死于晚期肿瘤。结论前列腺小细胞神经内分泌癌为罕见病,临床症状不典型,主要为血尿及排尿困难,需行病理检查确诊;由于治疗方法有限,生存期较短,预后差。
Objective To improve the understanding of prostate small cell neuroendocrine carcinoma. Methods One patient with small cell neuroendocrine carcinoma of 86 years old was diagnosed with hematuria accompanied with dysuria. The anus showed prostatic hyperplasia with moderate texture and normal prostate specific antigen (PSA) of 0.867ng / m L, B ultrasound Show: Hydronephrosis, bilateral ureteral expansion, more blood clots within the bladder, prostate hyperplasia. Combined with the literature analysis of incidence, pathogenesis, clinical features, diagnosis, treatment and prognosis. Results Under general anesthesia transurethral bladder pump and transurethral resection of the prostate. Prostate resection results show small cell neuroendocrine carcinoma. Postoperative CT suspicious pancreas has metastatic lesions, died of advanced tumors after 9 days. Conclusions Prostatic intracellular small cell neuroendocrine carcinoma is a rare disease with atypical clinical symptoms, mainly hematuria and dysuria. It needs to be confirmed by pathological examination. Due to limited treatment methods and short survival period, the prognosis is poor.