Zhang Jin, Dong Mei, Hu Xiaolei, Liu Lin, Li Shen, Li Chao, Yang Lijun, Xiao Yongqiang, Pang Shujian, Wang Chuan
Department of Urology, The First Hospital of Shijiazhuang, Shijiazhuang, Hebei, P.R. China.
Department of Surgery, The Affiliated Hospital of Hebei Science and Technology University, Shijiazhuang, Hebei, P.R. China.
Oncol Lett. 2016 Jan;11(1):792-794. doi: 10.3892/ol.2015.3920. Epub 2015 Nov 16.
Few cases of testicular metastases from prostate carcinoma have been reported, and asymptomatic metastases of prostate carcinoma to both the testis and epididymis are extremely rare. The current study presents the case of a 69-year-old male with testicular and epididymal metastases from prostate carcinoma. The patient was admitted to The First Hospital of Shijiazhuang with a 2-year history of lower urinary tract symptoms. Digital rectal examination revealed an enlarged multinodular prostate, and the serum prostate-specific antigen (PSA) level was >100 ng/ml. Magnetic resonance imaging showed prostate carcinoma with seminal vesicle involvement. A prostate biopsy showed prostate gland adenocarcinoma. The Gleason score was 3+3. The immunohistochemistry results were as follows: Prostatic acid phosphatase (+++), PSA (+++), P504s (+++), p63 (-) and cytokeratin 34βE12 (-), with a Ki-67 of ~5%. The patient was treated with a bilateral orchiectomy. The testicular pathology showed that the right testis and epididymis were invaded with metastatic adenocarcinoma. The left testis and epididymis were normal. The patient was treated with conventional flutamide endocrine therapy. At present the patient remains in a stable condition after 24 months of follow-up.
前列腺癌睾丸转移的病例报道较少，前列腺癌无症状转移至睾丸和附睾极为罕见。本研究报告了1例69岁男性前列腺癌睾丸及附睾转移的病例。该患者因下尿路症状2年入住石家庄市第一医院。直肠指检发现前列腺增大、呈多结节状，血清前列腺特异性抗原（PSA）水平>100 ng/ml。磁共振成像显示前列腺癌侵犯精囊。前列腺活检显示前列腺腺泡腺癌。Gleason评分为3+3。免疫组化结果如下：前列腺酸性磷酸酶（+++），PSA（+++），P504s（+++），p63（-），细胞角蛋白34βE12（-），Ki-67约为5%。该患者接受了双侧睾丸切除术。睾丸病理显示右侧睾丸和附睾被转移性腺癌侵犯。左侧睾丸和附睾正常。该患者接受了常规氟他胺内分泌治疗。目前，经过24个月的随访，患者病情稳定。
