Nakata Seiji, Nakano Katsuya, Takahashi Hirotomo, Shimizu Kazuhiko, Higashi Hiroomi, Ohki Kazunari
Department of Urology, Ashikaga Red Cross Hospital.
Nihon Hinyokika Gakkai Zasshi. 2005 May;96(4):507-10. doi: 10.5980/jpnjurol1989.96.507.
A 61-year-old man consulted our hospital complaining of high prostate specific antigen (PSA) value and difficulty to urinate. Prostate biopsy had been performed at another hospital, but did not reveal cancer. PSA was 18.5 ng/ml. Transrectal ultrasound-guided prostate biopsy was performed, but cancer was not detected. Later, PSA rose rapidly, and findings suggesting bone metastasis at right pubic bone and left sacro-ilial joint were found on computed tomography (CT), bone scintigraphy and magnetic resonance imaging (MRI). A repeat prostate biopsy was performed, but cancer was not detected from the prostate. On right pubic bone biopsy, poorly to moderately differentiated adenocarcinoma was detected. PSA immunohistochemical staining was positive, and the diagnosis was bone metastasis from prostate cancer. After endocrine therapy was started, PSA declined and bone metastasis disappeared on bone scintigraphy.
一名61岁男性因前列腺特异性抗原（PSA）值升高及排尿困难前来我院就诊。患者曾在另一家医院进行前列腺活检，但未发现癌症。PSA为18.5 ng/ml。随后进行了经直肠超声引导下前列腺活检，仍未检测到癌症。后来，PSA迅速升高，计算机断层扫描（CT）、骨闪烁显像和磁共振成像（MRI）检查发现右侧耻骨和左侧骶髂关节有骨转移迹象。再次进行前列腺活检，仍未在前列腺中检测到癌症。右侧耻骨活检发现低分化至中分化腺癌。PSA免疫组化染色呈阳性，诊断为前列腺癌骨转移。开始内分泌治疗后，PSA下降，骨闪烁显像显示骨转移消失。
