Division of Medical Oncology, Odette Cancer Centre, Toronto, ON. ; Department of Radiation Oncology, Odette Cancer Centre, Toronto, ON.
Curr Oncol. 2013 Feb;20(1):e48-51. doi: 10.3747/co.20.1206.
Avascular necrosis (avn) of the hip is a well-documented side effect of corticosteroid therapy, but it has also been described as a complication of radiation and chemotherapy. Many prostate cancer patients undergo treatment with all three of those therapeutic modalities, and yet reported cases of avn of the hip in prostate cancer patients are rare. Symptoms that might potentially alert physicians to this complication are nonspecific and may be attributed to cancer progression, in particular to progressive bone metastasis.Here, we report on a 79-year-old man diagnosed with castration-resistant prostate cancer whose diagnosis of avn of the hip was confounded by his underlying malignancy. We discuss risk factors and diagnostic clues in this differential diagnosis of acute hip pain in patients with castration-resistant prostate cancer. Physicians might maintain a high index of suspicion for avn of the hip in prostate cancer patients presenting with new-onset hip pain. Surgical intervention may help to prevent the appearance of avn-associated pain and the negative impact of advanced avn on overall quality of life.
股骨头缺血性坏死（AVN）是皮质类固醇治疗的一种明确的副作用，但它也被描述为放射治疗和化学治疗的并发症。许多前列腺癌患者接受了这三种治疗方式的治疗，但报告的前列腺癌患者股骨头缺血性坏死病例却很少见。可能提示医生发生这种并发症的症状是非特异性的，可能归因于癌症进展，特别是进展性骨转移。在这里，我们报告了一名 79 岁的男性被诊断为去势抵抗性前列腺癌，他的股骨头缺血性坏死的诊断因潜在的恶性肿瘤而变得复杂。我们讨论了这种去势抵抗性前列腺癌患者急性髋关节疼痛的鉴别诊断中的危险因素和诊断线索。对于出现新发髋关节疼痛的前列腺癌患者，医生可能需要保持对股骨头缺血性坏死的高度警惕。手术干预可能有助于预防与 AVN 相关的疼痛出现，以及晚期 AVN 对整体生活质量的负面影响。
