Nagashima Takao, Niiro Mako, Hirayama Kifu, Date Seiki, Okihara Koji, Mukaisho Ken-Ichi
The Department of Urology, Nagahama City Kohoku Hospital.
Hinyokika Kiyo. 2012 Aug;58(8):457-60.
We report a case of squamous differentiated prostate carcinoma that developed after combination endocrine therapy for adenocarcinoma of the prostate. The patient was a 68-year-old man who visited our hospital with microscopic hematuria. His serum prostate-specific antigen (PSA) level was 7. 06 ng/ml. Transperineal needle biopsy was performed and histological examinations indicated moderately differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8. Computed tomography showed swelling of left external iliac lymph node. The clinical stage was T3aN1M0. Six weeks after combination endocrine therapy using goserelin acetate and bicalutamide, the patient underwent radical prostatectomy and bilateral pelvic lymphadenectomy. Histopathological examination of the surgical specimen demonstrated squamous cell carcinoma of the prostate with very small areas of adenocarcinoma. The treatment measure was changed from endocrine therapy to combination chemotherapy consisting of docetaxel, cisplatin, and 5- FU. Eighteen month has passed after the surgery without any evidence of distant metastasis.
我们报告一例前列腺腺癌接受联合内分泌治疗后发生的鳞状分化前列腺癌病例。患者为一名68岁男性，因镜下血尿前来我院就诊。其血清前列腺特异性抗原（PSA）水平为7.06 ng/ml。行经会阴穿刺活检，组织学检查显示为中度分化腺癌，Gleason评分为4 + 4 = 8。计算机断层扫描显示左髂外淋巴结肿大。临床分期为T3aN1M0。在使用醋酸戈舍瑞林和比卡鲁胺进行联合内分泌治疗六周后，患者接受了根治性前列腺切除术和双侧盆腔淋巴结清扫术。手术标本的组织病理学检查显示为前列腺鳞状细胞癌，伴有非常小面积的腺癌。治疗措施从内分泌治疗改为由多西他赛、顺铂和5-氟尿嘧啶组成的联合化疗。术后已过去18个月，无远处转移迹象。
