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Spontaneous Regression Of Epstein-barr Virus-positive Primary Diffuse Large Cell B-cell Lymphoma Of The Urinary Bladder After The Cessation Of Enzalutamide

Ogihara et al., 2016Lymphoma

Ogihara, K., Kosaka, T., Kikuchi, E., Hongo, H., Mikami, S., & Oya, M. (2016). spontaneous Regression of Epstein-Barr Virus-Positive Primary Diffuse Large Cell B-Cell Lymphoma of the Urinary Bladder After the Cessation of Enzalutamide. Clinical genitourinary cancer, 14(2), e215–e218. https://doi.org/10.1016/j.clgc.2015.12.028

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Case Details

Disease Location

Urinary bladder

Personal Characteristics

66 -year-old male

Clinical Characteristics

Original presented in june 2003 because of high prostate-specific antigen. He was diagnosed with prostate cancer, and transrectal needle biopsy showed adenocarcinoma, gleason score of 4 + 3 - 7 imaging studies revealed invasion to the seminal vesicles and metastasis to the internal iliac ln, the tumor was believed to be clnical stage t2bn1mo minimum androgen blockade therapy was started oct 2003. 9 years later, his PSA level gradually increased and he was found to have developed crpc with bone metastases in aug 2013, he started therapy with docetaxel and prednisolone, PSA level was 39.79ng/ml. He went through 6 cycles of dp therapy and requested to stop because ofadverse effects. So he started radiation therapy for the metastatic foci and enzalutamide therapy in june 2014. PSA levels dropped to 0.01 again and in may 2015 was below 0.01ng/ml he underwent routine physical with MRI and a bladder tumor suspected to be stage t2 or higher was discovered. No prostate cancer was found. Urine cytology result was dass ii. Cystoscopy revealed a broad-based tumor at the dome of the bladder in june 2015, he stopped enzalutamide because of long qt intervals and an atypical t wave suspected to be drug-induced appeared on the ekg one month later MRI and transurethral resection was conducted the tumor was ebv-positive dlbcl final diagnosis of primary lymphoma of the urinary bladder

Remission Characteristics

After androgen blockade therapy, PSA level decreased and remained at <0.01 ng/ml for 9 years MRI in july 2015 revealed the bladder tumor spontaneously decreased in size and was considered stage t1, transurethral resection of the bladder tumor found the tymor decreased even further after the resection, bone marrow puncture and PET found no lymphoma except in the bladder after the cessation of enzalutamide, the dlbcl regressed spontaneously

Treatment & Mechanisms

Proposed Remission Mechanisms

An association between recovery from immunosuppression and sr

Clinical Treatment

Androgen blockade therapy docetaxel and prednisolone (dp) radiation therapy and enzalutamide

Non-Clinical Treatment

None reported