case_images: PMC11802412_01
case_images: Imaging studies before the treatment of ADT combination with PARPi. In PET/CT images, PET maximum-intensity-projection image (MIP) (A), Fused axial (B-D) showed intense diffuse accumulation of FDG in prostate mass (D, white arrow), lymph nodes (C, white arrow), pulmonary nodules (B, white arrow), bone lesions (A, red arrows). PSMA PET/CT images showed abnormal uptake of in bone lesions (H, red arrows), slight development of prostate mass (G, white arrow), lymph nodes (F, white arrow), pulmonary nodules (E, white arrow).
case_images: fonc-15-1508410-g001.jpg
case_images: PMC11802412_01_fonc-15-1508410-g001.jpg
case_images: f1
case_images: A subsequent prostate-specific membrane antigen PET-CT (PSMA PET-CT) revealed the same mass and metastatic lesions, excepting for the lesion in left lung ( Figure 1 ).
case_images: Biopsy specimen of the prostate. Hematoxylin-eosin (HE) and immunohistochemistry (IHC) staining of biopsy tissue from ONE same paraffin block. Tumor cells have round, ovoid, or spindled nuclei and scant cytoplasm with nesting, trabeculae or solid architectural patterns. Nuclear chromatin is finely granular and nucleoli are absent or inconspicuous (A, G). In solid area, the tumor cells are positive for neuroendocrine markers SYN (B, H), CgA (C, I), CD56(D, J) and INSM1(not provided) but negative for AR expression (E, K). As expected based on the elevated serum level of CEA, CEA is highly expressed (F, L).
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case_images: PMC11802412_01_fonc-15-1508410-g002.jpg
case_images: f2
case_images: Hematoxylin-eosin (HE) and immunohistochemistry (IHC) revealed prostate carcinoma with negative staining of androgen receptor (AR) and strong expression of NE markers, including SYN, CgA, CD56 and INSM1 ( Figure 2 ), indicating small cell neuroendocrine carcinoma (SCNEC) in 10 of 13 cores.
case_images: Imaging studies after the treatment of ADT combination with PARPi for two months. PET maximum-intensity-projection image (MIP) (A), Fused axial (B-D) images showed no evidence of FDG-concentrating active disease foci.
case_images: fonc-15-1508410-g003.jpg
case_images: PMC11802412_01_fonc-15-1508410-g003.jpg
case_images: f3
case_images: After receiving a combination treatment of ADT and Olaparib (a PARPi) for 8 weeks, tumor regressed radiologically ( Figure 3 ).