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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Long-term Outcome in Neuroendocrine Tumour of the Prostate: A Rare Case Report with Literature Review
Correspondence Address :
Dr. Laxman Pandey,
Department of Radiation Oncology, Rohilkhand Cancer Institute, Rohilkhand Medical College and Hospitals Campus, Pilibhit Bypass Road, Bareilly-243006, Uttar Pradesh, India.
E-mail: laxmanpnd06@gmail.com
Neuroendocrine (NE) prostate cancer is a rare and aggressive variant of prostate carcinoma, often presenting in advanced stages with widespread metastases and is associated with poor prognosis and limited treatment options. Hereby, the authors present the case of a 66-year-old male initially diagnosed with metastatic adenocarcinoma of the prostate with NE differentiation. Despite a normal Prostate-Specific Antigen (PSA) level, extensive metastatic disease involving lymph nodes, liver and bones was identified. The patient was treated with systemic chemotherapy (cisplatin and etoposide) and palliative radiotherapy. Subsequent progression led to brain metastases and bony metastasis, which were managed with whole brain radiotherapy and systemic second line chemotherapy. The patient tolerated treatment well and remains asymptomatic on follow-up. NE prostate cancer is a rare and aggressive entity with limited therapeutic options. Normal PSA levels in the setting of advanced disease should raise suspicion for NE differentiation. Early diagnosis and aggressive multimodal therapy, including high-dose radiotherapy, may improve symptom control and prolong survival in selected patients.
Chemotherapy, Metastasis, Prostate cancer, Survival
A 66-year-old male presented with the complaint of increased frequency of micturition associated with dysuria for two years. There was no history of any chronic illness or previous surgical intervention. Ultrasound pelvis was done that was suggestive of bladder outlet obstruction with grade 2 benign prostatic hyperplasia. Transurethral Resection of the Prostate (TURP) was done, which showed adenocarcinoma of prostate with Gleason score of 9 (4+5). The Prostatic Specific Antigen (PSA) was normal with a value of 2.4 ng/mL (normal: 0-4 ng/mL). He underwent bilateral orchidectomy in private hospital outside. Postoperative PSA level fell to 0.24 ng/mL. Patient was referred to our institution, where Positron Emission Tomography and Computed Tomography (PET-CT) were done. It showed increased uptake in bilateral peripheral zone of the prostate gland from the base to apex, infiltrating base of urinary bladder. Conglomerated lymph nodal mass was seen involving right common (1×1.5 cm), external and internal iliac (7×11.2×12.2 cm) group of lymph node. Non to low grade tracer avid multiple subcetimetric to enlarged hypodense lesions were noted in both lobes of liver largest 4×3.3 cm in segment V. Multiple lytic sclerotic lesions were seen in D4, D10 vertebrae, right ischium and right acetabulum (Table/Fig 1)a,(Table/Fig 1)b,(Table/Fig 1)c (Table/Fig 1)d. Slide en bloc review was done that was suggestive of small cell carcinoma on histopathological examination by Haematoxylin and Eosin (H&E), positive for AMACR (Alpha-methylacyl-CoA racemase) and negative for AR and GATA3. A final diagnosis of NE carcinoma of prostate was made (Table/Fig 2). Given metastatic disease, patient was planned for chemotherapy (cisplatin 25 mg/m2 and etoposide 100 mg/m2 d1-d3), three weekly cycles for six cycles. Due to complaints of back pain and clinical evidence of local tenderness over dorsal vertebrae, patient received palliative single fraction radiotherapy of 8 Gy to the D9-D11 vertebrae. Post-chemotherapy PET-CT showed favourable response to chemotherapy, with few sub-centimetric to enlarged bilateral common, internal and external iliac (2.2×1.4 cm) lymph nodes. Complete resolution of hypodense lesions in both lobes of liver was noted. Resolution of tracer avidity was noted in vertebrae, ischium and acetabulum (Table/Fig 3)a,(Table/Fig 3)b,(Table/Fig 3)c, (Table/Fig 3)d. The patient was kept on monthly follow-up. After one year of completion of chemotherapy, patient developed complaints of difficulty in adducting right arm. On examination sensory motor deficit was seen. Contrast-enhanced Magnetic Resonance Imaging (CEMRI) brain was done that revealed multiple well defined rounded hyperintense nodular lesions of varying sizes involving bilateral cerebral hemisphere, left cerebellar hemisphere and pons with central cystic areas and haemorrhagic residues on Susceptibility-weighted Imaging (SWI), largest in left precentral gyrus of size 2.4×1.8 cm (Table/Fig 4)a. Patient was planned for whole brain RT of 30 Gy in 10 fractions by two parallel opposed lateral portals. Patient tolerated RT well. At three months of follow-up, CEMRI brain was done that was suggestive of partial resolution of brain lesion with residual hyperintense lesion in left precentral gyrus 10×8 mm with diffusion restriction. As he was asymptomatic, hence was kept on monthly follow-up. After six months, patient developed diffuse back pain. On PET-CT, FDG uptake was seen at multiple vertebrae levels. In view of disease progression, he was planned for second line of chemotherapy (Inj. Cabazitaxel and inj carboplatin), three weekly cycles for six cycles (1),(2). Patient tolerated treatment well. At present, the patient has completed six months of follow-up and is asymptomatic and doing well. The recent CEMRI scan shows a stable brain lesion (Table/Fig 4)b. PET-CT scan also did not reveal any new metabolic uptake elsewhere in the body.
Prostate carcinoma is the most common non cutaneous malignancy. It is the second most common disease and the fifth major cause of cancer mortality among men in 2020, with an expected 1.4 million new cases and 375,000 deaths worldwide (3),(4). Adenocarcinoma is the most frequent type of prostate carcinoma and it most commonly originates in the glandular region. Small Cell Prostate Carcinoma (SCPC) is a rare form of extrapulmonary high-grade NE carcinoma accounting for <0.5% to 1% of all prostate cancers (4),(5). An aggressive clinical course and a bad prognosis distinguish it from adenocarcinoma of prostate. Locally progressed or metastatic illness is prevalent at the time of presentation. Primary SCPC is a rare phenomenon that can develop spontaneously, although a more common variety can develop in the later stages of adenocarcinoma after hormone therapy (6). The current report describes aggressive nature of NE tumour that rapidly metastasised during treatment. Within a year, disease metastasised to bone and brain. However, therapy proved to be an effective modality to treat the metastatic lesions.
The NE prostate carcinoma is a disease that progresses from prostate adenocarcinoma to small cell carcinoma in either pure or mixed forms. NE cells are generally present in the periurethral and ductal regions of normal prostatic tissue. They plays an important role in the growth and secretory functions of the prostatic epithelial tissue. The major recognisable features of these cells are that they do not express androgen receptors on their surface and also lack PSA on Immunohistochemistry (IHC). They are identified by other markers on IHC like synaptophysin and chromogranin (7). Two important mechanisms have been hypothesised regarding the pathogenesis of prostate NE tumours. Both in-vivo and in vitro studies have provided evidence that androgen depletion may cause transdifferentiation of carcinoma cells into AR-negative NE cells. Based on autopsy reports, nearly 10% of NE tumours arise from androgen-resistant disease after long-term Androgen Deprivation Therapy (ADT) use. Another less common mechanism is the development of tumour from existing NE cells either in pure form that develops from multipotent stem cells present in the organ or mixed forms (8),(9).
In 2016, World Health Organisation (WHO) reclassified NE tumours of prostate as: NE differentiation of adenocarcinoma, well-differentiated NE tumour or carcinoid tumours and poorly differentiated NE small or large cell tumours (10). Degree of NE differentiation directly correlates with the aggressiveness of disease. It is not uncommon for this variant of prostatic carcinoma to present with locally advanced and metastatic stage. Given the propensity for occult metastases, even the localised NE tumours are treated aggressively. Systemic therapy is the mainstay of treatment with localised radiotherapy in early stage. Surgery has a limited role in this variant. There is still no effective treatment guideline for malignant NE tumour and treatment is extrapolated from the small cell lung tumours. However, therapies directed towards NE hormones and their antagonists like somatostatin, serotonin and bombesin have been experimented (7).
In present case, patient presented with metastatic disease at the time of presentation. When patient experienced local symptoms, disease was already metastasised to regional lymph nodes with distant metastases to liver and bone. This shows the aggressive nature of the disease. Even after widespread disease, PSA was in a normal range, which gave first expression that disease is not arising from the prostatic epithelium. Also, on IHC, Androgen Receptor (AR) was negative which indicated that disease has NE differention. However, Alpha-methylacyl-CoA Racemase (AMACR) was positive, which is mitochondrial and peroxisomal enzyme that is overexpressed in prostate cancer. Based on this, it was categorised as per WHO classification of adenocarcinoma with NE differentiation. Given metastatic disease, patient received systemic chemotherapy. Platinum-based chemotherapy is a first-line treatment in such patients, which is based on single-arm phase II studies and retrospective studies that included cisplatin/ carboplatin with etoposide/ docetaxel (11). According to Palmgren JS et al., chemotherapy and local RT provide a survival advantage in patients with low PSA level, poorly differentiated tumour, inadequate response to hormonal therapy and rapidly metastasising disease (12). Despite the long course of chemotherapy and local RT, the outcome in these patients is unfavourable. The median survival depends upon the stage of disease and type of differentiation, ranging from 9-24 months (13),(14). The review of literature has been depicted in (Table/Fig 5) (13),(14),(15),(16),(17). In the present case, patient has survived three years post-diagnosis with regular monitoring based on clinical and radiological examination.
The NE prostate cancer is a rare variant which generally presents with widespread metastasis. Despite aggressive multimodality treatment, the outcome is dismal. However, due to rarity of disease, there is lack of treatment guidelines. NE tumours must be suspected if patients present with urinary symptoms with normal PSA level and prostatic mass. Early detection and appropriate systemic and local treatment may prevent the widespread metastases of disease and improve the outcome. High dose radiotherapy to the local metastatic site may help to ablate the disease and provide symptomatic relief with improved survival.
DOI: 10.7860/JCDR/2026/88399.24328
Date of Submission: Feb 20, 2026
Date of Peer Review: Apr 02, 2026
Date of Acceptance: Mar 13, 2026
Date of Publishing: Sep 01, 2026
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 16, 2026
• Manual Googling: Mar 09, 2026
• iThenticate Software: Mar 11, 2026 (4%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com