{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:04:04Z","timestamp":1785135844188,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neuroendocrine prostate cancer is a rare and highly aggressive variant of prostate cancer with a poor prognosis. We report a case in which metastatic castration\u2010sensitive prostate cancer directly transformed into neuroendocrine prostate cancer without a corresponding increase in prostate\u2010specific antigen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>An 86\u2010year\u2010old male with severe acute renal failure demonstrated a prostate\u2010specific antigen level of 306\u2009ng\/mL and a Gleason score of 4\u2009+\u20095 on prostate biopsy. Imaging revealed lung, bone, and lymph node metastases, leading to a diagnosis of high\u2010risk metastatic castration\u2010sensitive prostate cancer. Abiraterone acetate was initiated immediately. Nineteen months later, multiple liver metastases were detected despite stable prostate\u2010specific antigen levels. The patient died 4\u2009months later. Autopsy revealed widespread metastases, all histologically confirmed as neuroendocrine prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Strong androgen receptor suppression in metastatic castration\u2010sensitive prostate cancer can lead to aggressive radiographic progression without prostate\u2010specific antigen elevation, underscoring the limitations of antigen\u2010based monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70196","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:19:09Z","timestamp":1779941949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroendocrine Transformation Without\n                    <scp>PSA<\/scp>\n                    Elevation in High\u2010Risk Metastatic Castration\u2010Sensitive Prostate Cancer Under Androgen Receptor Signaling Inhibition: A Case Report"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3245-1370","authenticated-orcid":false,"given":"Yoshihiro","family":"Nakagami","sequence":"first","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Ohnuma","sequence":"additional","affiliation":[{"name":"Department of Pathology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Tamaoka","sequence":"additional","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4505-7513","authenticated-orcid":false,"given":"Motoki","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3129-9079","authenticated-orcid":false,"given":"Kazuhiko","family":"Oshinomi","sequence":"additional","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Urology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Oohira","sequence":"additional","affiliation":[{"name":"Department of 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