{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T04:40:09Z","timestamp":1751863209988,"version":"3.41.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Large cell neuroendocrine carcinoma of the prostate is an extremely rare malignant subgroup with limited reported cases. Little is known about its pathological characteristics, treatment options and long-term prognosis. In this case, we report a young patient presenting with painless gross hematuria for 3 months, accompanied with elevated serum total prostate-specific antigen (tPSA) level of 83.7 ng\/ml. Magnetic resonance imaging (MRI) and 18F-FDG Positron Emission Tomography - Computed Tomography (\u00b9<jats:sup>8<\/jats:sup>F-FDG PET\/CT) indicated giant prostate mass, which metastasized to bilateral lungs, bones and lymph nodes. Prostate biopsy and transurethral resection of the prostate confirmed the diagnosis of adenocarcinoma with a Gleason score of 4 + 5. After receiving 12 months of goserelin acetate, rezvilutamide and six cycles of docetaxel, the patient further underwent laparoscopic radical prostatectomy (LRP). Immunohistochemical analysis (Syn+\/CgA+\/AR\u2212) combined with treatment history revealed a histopathological diagnosis of treatment-related LCNEPC. Subsequently, the patient then received immunotherapy with serplulimab (300 mg) and the EP regimen (combining etoposide and cisplatin) chemotherapy. After six cycles of chemo-immunotherapy, further examination indicated reduction in size of multiple lymph nodes and lung metastases by March 2025. Here we reported a rare case of treatment-related LCNEPC, who had experienced systematic therapy with comprehensive care. These diagnostic and therapeutic approaches may improve the management capability and highlight the critical role of multimodal strategies in the subsequent cases.<\/jats:p>","DOI":"10.3389\/fonc.2025.1617699","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T04:10:49Z","timestamp":1751861449000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment-related pure large-cell neuroendocrine carcinoma of the prostate with systemic metastases in a young adult: a rare case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Baolin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renpeng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixin","family":"Ling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6880","article-title":"Clinical and genomic characterization of treatment-emergent small-cell neuroendocrine prostate cancer: A multi-institutional prospective study","volume":"36","author":"Aggarwal","year":"2018","journal-title":"J Clin Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.07.002","article-title":"The 2022 world health organization classification of tumors of the urinary system and male genital organs-part B: prostate and urinary tract tumors","volume":"82","author":"Netto","year":"2022","journal-title":"Eur Urol."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-12-3791","article-title":"Platinum-based chemotherapy for variant castrate-resistant prostate cancer","volume":"19","author":"Aparicio","year":"2013","journal-title":"Clin Cancer Res"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00507-1","article-title":"Rezvilutamide versus bicalutamide in combination with androgen-deprivation therapy in patients with high-volume, metastatic, hormone-sensitive prostate cancer (CHART): a randomised, open-label, phase 3 trial","volume":"23","author":"Gu","year":"2022","journal-title":"Lancet Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-20-0394","article-title":"Non-BRCA DNA damage repair gene alterations and response to the PARP inhibitor rucaparib in metastatic castration-resistant prostate cancer: analysis from the phase II TRITON2 study","volume":"26","author":"Abida","year":"2020","journal-title":"Clin Cancer Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30684-9","article-title":"Olaparib in patients with metastatic castration-resistant prostate cancer with DNA repair gene aberrations (TOPARP-B): a multicentre, open-label, randomised, phase 2 trial","volume":"21","author":"Mateo","year":"2020","journal-title":"Lancet Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz394.043","article-title":"Pre-specified interim analysis of GALAHAD: A phase II study of niraparib in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) and biallelic DNA-repair gene defects (DRD)","volume":"30","author":"Smith","year":"2019","journal-title":"Ann Oncol"},{"key":"B8","article-title":"Neuroendocrine differentiation of prostate cancer: a review","volume":"2","author":"Parimi","year":"2014","journal-title":"Am J Clin Exp Urol."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/00129039-200209000-00016","article-title":"Stereologic estimation of the number of neuroendocrine cells in normal human prostate detected by immunohistochemistry","volume":"10","author":"Santamaria","year":"2002","journal-title":"Appl Immunohistochem Mol Morphol."},{"key":"B10","article-title":"Human prostatic endocrine-paracrine (APUD) cells. 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