De novo small cell neuroendocrine carcinoma of the prostate with extremely elevated PSA and Gleason score 5 + 5: a case report

This represents the first reported case of <i>de novo</i> SCNEPC with Gleason score 5 + 5, demonstrating that intensive multimodal therapy combining platinum-based chemotherapy with contemporary androgen receptor pathway inhibition can achieve profound and sustained responses in this aggressive variant typically associated with dismal outcomes. The substantial adenocarcinoma component may have contributed to the exceptional treatment response.