A first Japanese case of neuroendocrine prostate cancer accompanied by lung and brain metastasis with somatic and germline BRCA2 mutation

Pathol Int. 2019 Dec;69(12):715-720. doi: 10.1111/pin.12860. Epub 2019 Oct 20.

Abstract

Germline mutations and copy number changes in DNA damage repair (DDR) genes such as BRCA2 are associated with aggressive forms of prostate cancer (PCa). Although the prevalence of BRCA2 variants in PCa is increasing in Japan, the genomic and biological implications in Japanese patients are unclear. An 81-year-old male presented with prostatic adenocarcinoma with neuroendocrine differentiation accompanied by metastatic lung nodule and brain metastases. Platinum-based doublet chemotherapy combined with etoposide resulted in partial and complete remissions of brain and lung metastases, respectively. Next-generation sequencing of biopsy and peripheral blood samples demonstrated a somatic BRCA2 mutation at c.7008-2A>C and a germline mutation at p.E2877*. The patient's son had been diagnosed with breast cancer 2.5 years ago and was found to have the same germline BRCA2 mutation. BRCA2 mutation increases the risks of aggressive PCa and other cancer types in Japanese males. These forms may be highly responsive to platinum-based chemotherapy.

Keywords: BRCA2; DNA damage repair genes; NEPC; platinum-based chemotherapy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • BRCA2 Protein / genetics*
  • Biopsy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy
  • Carcinoma, Neuroendocrine / diagnostic imaging*
  • Carcinoma, Neuroendocrine / genetics
  • Carcinoma, Neuroendocrine / pathology
  • Carcinoma, Neuroendocrine / therapy
  • Germ-Line Mutation
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Japan
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / secondary
  • Lung Neoplasms / therapy
  • Male
  • Neoplasm Metastasis
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / genetics
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy
  • Sequence Analysis, DNA

Substances

  • BRCA2 Protein
  • BRCA2 protein, human