Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan.
Int J Clin Oncol. 2010 Feb;15(1):93-6. doi: 10.1007/s10147-009-0004-6. Epub 2010 Jan 20.
We describe a case of embryonal rhabdomyosarcoma of the prostate in a 20-year-old man with a history of acute lymphatic leukemia at 6 years of age. He presented with gross hematuria and high fever. The level of prostate-specific antigen (PSA) was 27.9 ng/ml. Computed tomography revealed a suspected infectious cyst in the prostate. After antibiotic treatment was begun, the PSA level normalized. However, the patient later suffered bladder tamponade. A biopsy of the prostate revealed embryonal rhabdomyosarcoma. Chemotherapy with vincristine, actinomycin D, cyclophosphamide, and ifosfamide was begun according to the treatment protocol of the Japan Rhabdomyosarcoma Study Group. The tumor shrank, and partial remission was obtained after 1 course of chemotherapy. During treatment for acute lymphatic leukemia at the age of 6 years, the patient had been exposed to a cumulative radiation dose of 10 Gy across his entire body. It has been reported that 88% of postradiation sarcomas are KIT-positive, and we suspect that our patient suffered a postradiation sarcoma, because his tumor was KIT-positive. This is the first report of postradiation sarcoma manifesting as an embryonal rhabdomyosarcoma of the prostate.
我们描述了一例 20 岁男性前列腺胚胎性横纹肌肉瘤病例，该患者在 6 岁时患有急性淋巴细胞白血病。他以肉眼血尿和高热为首发症状。前列腺特异性抗原（PSA）水平为 27.9ng/ml。计算机断层扫描显示前列腺疑似感染性囊肿。开始抗生素治疗后，PSA 水平正常化。然而，患者随后出现膀胱填塞。前列腺活检显示胚胎性横纹肌肉瘤。根据日本横纹肌肉瘤研究组的治疗方案，开始用长春新碱、放线菌素 D、环磷酰胺和异环磷酰胺进行化疗。肿瘤缩小，1 个疗程化疗后获得部分缓解。在 6 岁时治疗急性淋巴细胞白血病期间，患者全身接受了累积 10Gy 的辐射剂量。据报道，88%的放射性肉瘤为 KIT 阳性，我们怀疑患者患有放射性肉瘤，因为他的肿瘤为 KIT 阳性。这是首例表现为前列腺胚胎性横纹肌肉瘤的放射性肉瘤报道。
