Yi Lu, Wang Yinhuai
Department of Urology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Jul;34(7):646-50.
To improve the awareness of rare mixed prostatic carcinoma.
We reviewed the clinical data of 5 patients with prostatic mixed tumor and relevant literature to explore diagnosis and treatment for it.
Patient 1 with mixed small cell carcinoma and adenocarcinoma of the prostate who underwent transurethral electrovaporization of the prostate (TUVP) and flumamide therapy died of lung metastasis 7 months later. Patient 2 with mixed small cell carcinoma and adenocarcinoma of the prostate who underwent TUVP and bilateral testicular resection died of lung metastasis 10 months later. Patient 3 with adenosquamous carcinoma of the prostate who underwent TUVP, radiation therapy and flumamide therapy died of multiple organ failure 8 months later because of the lung, liver, and multiple bone metastasis. Patient 4 with prostatic adenosquamous carcinoma who underwent cystoprostatectomy combined with urinary diversion has already survived for 1 year. Patient 5 with prostatic carcinosarcoma who underwent cystoprostatectomy, urinary diversion, pelvic lymphadenectomy, and radiation therapy died of lung metastasis 13 months later.
Mixed prostatic carcinoma is quite aggressive with bad prognosis. Its diagnosis relies on detailed pathological examination and immunohistochemical techniques. Patients with prostate adenocarcinoma should be followed up timely after endocrine treatment or radiotherapy. Radical surgery is most effective for mixed prostatic carcinoma.
提高对罕见的混合性前列腺癌的认识。
我们回顾了5例前列腺混合瘤患者的临床资料及相关文献，以探讨其诊断和治疗方法。
病例1为前列腺小细胞癌和腺癌混合，接受经尿道前列腺汽化术（TUVP）及氟他胺治疗，7个月后死于肺转移。病例2为前列腺小细胞癌和腺癌混合，接受TUVP及双侧睾丸切除术，10个月后死于肺转移。病例3为前列腺腺鳞癌，接受TUVP、放疗及氟他胺治疗，8个月后因肺、肝及多处骨转移死于多器官功能衰竭。病例4为前列腺腺鳞癌，接受膀胱前列腺切除术及尿流改道术，已存活1年。病例5为前列腺癌肉瘤，接受膀胱前列腺切除术、尿流改道术、盆腔淋巴结清扫术及放疗，13个月后死于肺转移。
混合性前列腺癌侵袭性强，预后差。其诊断依赖详细的病理检查及免疫组化技术。前列腺腺癌患者在内分泌治疗或放疗后应及时随访。根治性手术对混合性前列腺癌最为有效。
