Kotake Y, Gohji K, Suzuki T, Watsuji T, Kusaka M, Takahara K, Ubai T, Noumi H, Inamoto T, Shibahara N, Ueda H, Katsuoka Y
Department of Urology, Osaka Medical College, Takatsuki, Japan.
Int J Urol. 2001 Feb;8(2):83-6. doi: 10.1046/j.1442-2042.2001.00245.x.
A 58-year-old man presented with dysuria at the Osaka Medical College Hospital in November 1996. Laboratory examination revealed elevated serum prostate-specific antigen (PSA) to > 100 ng/mL. Adenocarcinoma of the prostate with metastasis to the bone was diagnosed after a biopsy of the prostate and bone scintigraphy; hormonal therapy was administered. Although bone metastasis was well controlled and the serum PSA level declined to within normal levels (2.0 ng/mL), several painless nodules were found on the penile glans. Biopsy of the nodules showed that the penile tumor was a metastasis from the prostate cancer. The patient underwent partial penectomy for relief from penile pain. The serum PSA level showed no elevation 3 months after the partial penectomy, suggesting that careful observation of prostate cancer patients is necessary, even when oseous metastasis is well controlled and serum PSA levels are kept within normal ranges by hormonal therapy. The case also indicates that urologists should consider the possibility of metastasis to the penis from prostate cancer.
1996年11月，一名58岁男性因排尿困难就诊于大阪医科大学医院。实验室检查显示血清前列腺特异性抗原（PSA）升高至>100 ng/mL。经前列腺活检和骨闪烁显像后，诊断为前列腺腺癌伴骨转移；给予激素治疗。尽管骨转移得到良好控制，血清PSA水平降至正常范围（2.0 ng/mL）以内，但在阴茎龟头发现了几个无痛性结节。结节活检显示阴茎肿瘤为前列腺癌转移灶。患者接受了部分阴茎切除术以缓解阴茎疼痛。部分阴茎切除术后3个月，血清PSA水平未升高，这表明即使骨转移得到良好控制且激素治疗使血清PSA水平保持在正常范围内，对前列腺癌患者进行仔细观察也是必要的。该病例还表明，泌尿外科医生应考虑前列腺癌转移至阴茎的可能性。
