A 72-year-old man was diagnosed with prostate cancer 4 years ago and underwent heavy particle and hormone therapies at another hospital. A contrast-enhanced computed tomography (CT) scan, performed because of elevated hepatobiliary enzymes, did not show any abnormalities in the prostate. It did, however, show multiple hepatic masses, a mass shadow in the rectum, and enlarged surrounding lymph nodes. CS revealed a 40 mm submucosal tumor in the rectum with a depression in the apex. The tumor was biopsied and diagnosed as endocrine cell carcinoma. Chemotherapy initiation reduced the tumor size; however, a genomic analysis using a gene panel revealed the presence of prostate cancer-specific fusion gene TMPRSS2-ERG. This report describes a rare case in which neuroendocrine differentiation of prostate cancer was seen after hormone therapy, and the metastatic lesion grew rapidly and invaded the rectum.
"},{"@language":"ja","@value":"患者は72歳の男性．４年前に前立腺癌の診断で重粒子線治療・内分泌療法が施行された．肝胆道系酵素の上昇のため施行した造影CT検査で前立腺に異常を指摘しえなかったが，多発肝腫瘤と直腸の腫瘤影および周囲のリンパ節腫大を認めた．CSで直腸Rbに頂部に陥凹を伴う40mm大の粘膜下腫瘍様隆起を認め，生検では内分泌細胞癌であった．直腸内分泌細胞癌と考え化学療法を開始し腫瘍は縮小傾向であったが，遺伝子パネルによるがんゲノム検査で前立腺癌特異的融合遺伝子であるTMPRSS2-ERGを認めた．本症例は前立腺癌が内分泌療法により神経内分泌分化を起こし，転移巣が急速に増大して直腸浸潤した極めて稀で貴重な症例と考えられた．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410295823371007236","@type":"Researcher","foaf:name":[{"@language":"en","@value":"IHARA Yutaro"},{"@language":"ja","@value":"井原 勇太郎"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院 病態機能内科学"},{"@language":"en","@value":"Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University."}]},{"@id":"https://cir.nii.ac.jp/crid/1410295823371007235","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KAWATOKO Shinichiro"},{"@language":"ja","@value":"川床 慎一郎"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Anatomic Pathology, Pathological sciences, Graduate School of Medical Sciences, Kyushu University."},{"@language":"ja","@value":"九州大学大学院医学研究院 形態機能病理学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410295823371007232","@type":"Researcher","foaf:name":[{"@language":"en","@value":"TORISU Takehiro"},{"@language":"ja","@value":"鳥巣 剛弘"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University."},{"@language":"ja","@value":"九州大学大学院医学研究院 病態機能内科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410295823371007233","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MIZUE Ryutaro"},{"@language":"ja","@value":"水江 龍太郎"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University."},{"@language":"ja","@value":"九州大学大学院医学研究院 病態機能内科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410295823371007234","@type":"Researcher","foaf:name":[{"@language":"en","@value":"FUJIWARA Minako"},{"@language":"ja","@value":"藤原 美奈子"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州医療センター 検査科病理・病理診断科"},{"@language":"en","@value":"Department of Pathology, National Hospital Organization Kyushu Medical Center."}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"03871207"},{"@type":"LISSN","@value":"03871207"},{"@type":"EISSN","@value":"18845738"}],"prism:publicationName":[{"@language":"ja","@value":"日本消化器内視鏡学会雑誌"},{"@language":"en","@value":"GASTROENTEROLOGICAL ENDOSCOPY"},{"@language":"en","@value":"Gastroenterol. Endosc."},{"@language":"en","@value":"Gastroenterol Endosc"},{"@language":"en","@value":"gastroenterol endosc"},{"@language":"en","@value":"GASTROENTEROL ENDOSC"},{"@language":"ja","@value":"日本消化器内視鏡学会雑誌"},{"@language":"en","@value":"Gastroenterological Endoscopy"}],"dc:publisher":[{"@language":"en","@value":"Japan Gastroenterological Endoscopy Society"},{"@language":"ja","@value":"一般社団法人 日本消化器内視鏡学会"}],"prism:publicationDate":"2023","prism:volume":"65","prism:number":"4","prism:startingPage":"353","prism:endingPage":"360"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2023205850"}],"availableAt":"2023","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%89%8D%E7%AB%8B%E8%85%BA%E7%99%8C","dc:title":"前立腺癌"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%89%8D%E7%AB%8B%E8%85%BA%E5%B0%8F%E7%B4%B0%E8%83%9E%E7%99%8C","dc:title":"前立腺小細胞癌"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%86%85%E5%88%86%E6%B3%8C%E7%B4%B0%E8%83%9E%E7%99%8C","dc:title":"内分泌細胞癌"},{"@id":"https://cir.nii.ac.jp/all?q=%E7%A5%9E%E7%B5%8C%E5%86%85%E5%88%86%E6%B3%8C%E5%88%86%E5%8C%96","dc:title":"神経内分泌分化"},{"@id":"https://cir.nii.ac.jp/all?q=%E7%9B%B4%E8%85%B8%E8%BB%A2%E7%A7%BB","dc:title":"直腸転移"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2010569441"}]}