Gentile P S, Carloss H W, Huang T Y, Yam L T, Lam W K
Division of Medical Oncology, James Graham Brown Cancer Center, University of Louisville, KY 40292.
Cancer. 1988 Aug 15;62(4):711-5. doi: 10.1002/1097-0142(19880815)62:4<711::aid-cncr2820620411>3.0.co;2-6.
Recognition of disseminated adenocarcinomas potentially responsive to current treatment programs is an important objective in the management of cancer patients. Metastatic adenocarcinoma of the prostate gland is a malignant entity which often can be palliated effectively by hormonally based therapeutic strategies. In cases of metastatic prostate cancer presenting with typical clinical features, the correct diagnosis can be readily achieved, but in patients with less obvious presentations the diagnosis of prostatic carcinoma may be overlooked. In the current report, a group of elderly men presenting with a clinical syndrome resembling either metastatic primary adenocarcinoma of the lung or primary adenocarcinoma of the lung coexisting with prostate cancer were found in fact to have metastatic prostatic carcinoma as their sole disease process. In each case, cytologic characterization of clinically involved tissue specimens by the prostate specific antigen and prostatic acid phosphatase immunohistochemical markers enabled clinical investigators to arrive at the correct diagnosis. Other clinical features, such as a positive bone scan and an enlarged prostate gland on physical exam and/or radiographic studies were noted to be present in these patients. All the patients in the current series responded to hormonal treatment regimens once the diagnosis of metastatic prostate cancer had been established. In elderly male patients presenting with what appears to be primary adenocarcinoma of the lung, the diagnosis of metastatic prostate cancer should be considered and when necessary evaluated by the use of appropriate clinical and immunohistochemical studies.
识别可能对当前治疗方案有反应的播散性腺癌是癌症患者管理中的一个重要目标。前列腺转移性腺癌是一种恶性实体，通常可以通过基于激素的治疗策略有效缓解。在具有典型临床特征的转移性前列腺癌病例中，正确诊断很容易实现，但在表现不那么明显的患者中，前列腺癌的诊断可能会被忽视。在本报告中，发现一组临床表现类似肺转移性原发性腺癌或与前列腺癌共存的肺原发性腺癌的老年男性，实际上其唯一的疾病过程是前列腺转移性癌。在每一个病例中，通过前列腺特异性抗原和前列腺酸性磷酸酶免疫组化标记对临床受累组织标本进行细胞学特征分析，使临床研究人员能够得出正确诊断。还注意到这些患者存在其他临床特征，如骨扫描阳性、体格检查和/或影像学检查显示前列腺肿大。一旦确诊为转移性前列腺癌，本系列中的所有患者对激素治疗方案均有反应。对于表现为似乎是肺原发性腺癌的老年男性患者，应考虑转移性前列腺癌的诊断，并在必要时通过适当的临床和免疫组化研究进行评估。
