Multidisciplinary therapy targeting histological heterogeneity in prostate cancer with bone marrow carcinomatosis: A case report.

Prostate cancer with bone marrow carcinomatosis is rare and has a poor prognosis. A 68-year-old man with severe thrombocytopenia was diagnosed with prostate cancer based on MRI and bone marrow biopsy findings. Initial treatment with a GnRH antagonist and apalutamide showed limited efficacy for thrombocytopenia despite PSA response, prompting the addition of carboplatin and etoposide (CE) chemotherapy. Thrombocytopenia resolved following CE chemotherapy. After four CE cycles, ProGRP stabilized and PSA decreased significantly. Tumor control was maintained for a year with hormonal therapy. This case underscores the need for early, multidisciplinary treatment in histologically heterogeneous prostate cancer.