Neuroendocrine cancer of the prostate. Two case reports

Background: Neuroendocrine cancer of the prostate can present in diverse clinical pictures, potentially hampering the diagnosis and probably leading to underdiagnosis. Methods: Two cases are presented corresponding respectively to two forms of the disease: de novo neuroendocrine cancer and dedifferenciation of an adenocarcinoma of the prostate to neuroendocrine cancer under long term luteinising hormone releasing hormone (LHRH) agonist treatment. Results: Suspicion of neuroendocrine cancer may be raised in prostate cancer patients presenting either clinical or radiological metastatic progression without prostate specific antigen (PSA) rise, or relatively extended metastatic disease right at diagnosis associated to relatively low PSA, yet any non-pulmonary visceral metastases. Neuroendocrine cancer of the prostate can also turn out to be the origin of an adenocarcinoma of unknown primary. Conclusion: In case these considerations are respected the risk of missing the correct diagnosis of a neuroendocrine cancer of the prostate may be minimised.

Case series of skin symptoms possibly related to SARS-CoV-2 infection admitted to Heim Pal children's hospital and review of the literature

The COVID-19 pandemic, which started in China in December2019, is caused by the SARS-CoV-2 virus. In addition to severe, even life-threatening respiratory symptoms caused by the SARS-CoV-2 virus, a number of systemic and atypical skin symptoms have developed in young patients. This article presents cases of skin symptoms possibly provoked by SARS-CoV-2 virus attended to Pal Heim Children's Hospital from 15 November to 31 December 2020. Four chilblain-like acral lesions and one case of multiple organ failure similar to Kawasaki disease are presented. The SARS-COV-2 PCR test was negative in all cases, however, high antibody titer was found by serologic testing for antibodies in two cases. In another case, the first antibody test found doubtful positivity, however, high antibody levels were confirmed one month later. Based on our findings, it is presumed, that pernio-like symptoms and multiple organ failure similar to Kawasaki disease could be late symptoms of COVID-19. The authors also summarize the most common skin symptoms associated with SARS-CoV-2 infection in children, highlighting the different pediatric aspects from adult cases.