Radical cystoprostatectomy with orthotopic neobladder for a case of treatment emergent neuroendocrine prostate cancer presenting as bladder mass with hematuriaea rare instance of tumor remission after local control

Dear editor Treatment emergent neuroendocrine prostate cancer(tNEPC)is most commonly observed after development of resistance to androgen deprivation therapy(ADT)and is associated with rapid progression and widespread metastases with survival less than 1 year from diagnosis[1].Management of this disease is mainly through cytotoxic chemotherapy and there is no published evidence of treating the primary prostatic lesion in this stage of the disease,unlike that of localized prostate cancer or castrate sensitive metastatic prostate cancer[2].In this letter,we report the only known case of t-NEPC who presented with an initial diagnosis of bladder urothelial carcinoma and was treated by early radical surgery and chemotherapy,which led to longterm disease control and preservation of quality of life.