Shinn Brianna Jeanette, Greenwald David W, Ahmad Navid
The Commonwealth Medical College, Scranton, Pennsylvania, USA.
Medical Oncology Associates, Kingston, Pennsylvania, USA.
BMJ Case Rep. 2015 May 20;2015:bcr2015209914. doi: 10.1136/bcr-2015-209914.
A 71-year-old man presented with a firm left testicle 15 years after being diagnosed with prostatic adenocarcinoma. After the initial diagnosis, the patient underwent a radical prostatectomy. He received radiation therapy 5 years after surgery for a slightly elevated prostate-specific antigen (PSA) level and a negative metastatic workup. Eight years later, the patient's PSA rose to 3.38 ng/mL and he was started on intermittent Lupron therapy. It was then 3 years later when the patient discovered the testicular mass. At that time, his PSA level was 2.98 ng/mL. He underwent a left orchiectomy which demonstrated metastatic prostatic adenocarcinoma. Currently, the patient is doing well 3 months postorchiectomy and is now receiving continuous testosterone suppression therapy. This case report discusses the unique modes of spread from the prostate to the testicle as well as the importance of follow-up care in patients with prostate cancer, especially in the setting of low PSA levels.
一名71岁男性在被诊断为前列腺腺癌15年后出现左侧睾丸质地变硬。初次诊断后，患者接受了根治性前列腺切除术。术后5年，因前列腺特异性抗原（PSA）水平略有升高且转移检查结果为阴性，他接受了放射治疗。8年后，患者的PSA升至3.38 ng/mL，开始接受间歇性亮丙瑞林治疗。3年后，患者发现了睾丸肿块。当时，他的PSA水平为2.98 ng/mL。他接受了左侧睾丸切除术，结果显示为转移性前列腺腺癌。目前，患者在睾丸切除术后3个月情况良好，现正在接受持续的睾酮抑制治疗。本病例报告讨论了前列腺癌转移至睾丸的独特途径，以及前列腺癌患者随访护理的重要性，尤其是在PSA水平较低的情况下。
