Moriyama Hiroyuki, Kajiwara Mitsuru, Yonehara Shuji
The Department of Urology, JA Onomichi General Hospital.
The Department of Pathology, JA Onomichi General Hospital.
Hinyokika Kiyo. 2016 May;62(5):259-64.
The patient was a 73-year-old man who visited our hospital with asymptomatic gross hematuria. Cystoscopy revealed a bladder tumor in two places. Serum prostatic specific antigen was normal (2.535 ng/ml). Transurethral resection of bladder tumors was performed. In order to complete resection of bladder tumor, transurethral resection of right lobe of the prostate whitch had protruded into the bladder, was needed. Histology of the prostatic tissue revealed squamous cell carcinoma with no grandular and acinar structures. Serum SCC-antigen level was evaluated (6.2 ng/ml) after establishment of the diagnosis. Thoraco-abdominal computed tomography and 18-fluorodeoxyglucose positron emission tomography/ computed tomography ((18)F-FDG PET/CT) showed prostate cancer and multiple metastases in the lymph nodes, such as right external iliac, right common iliac, para-aortic and left supraclavicular region. The patient received external radiation therapy to the prostate and underwent systemic chemotherapy using docetaxel. After 2 courses of docetaxel therapy, multiple lymph nodes metastases were reduced and serum SCC-antigen level was normalized. Docetaxel therapy could not be continued because of a side effect of interstitial pneumonia.
患者为一名73岁男性,因无症状肉眼血尿前来我院就诊。膀胱镜检查发现膀胱有两处肿瘤。血清前列腺特异性抗原正常(2.535 ng/ml)。遂行经尿道膀胱肿瘤切除术。为完整切除膀胱肿瘤,需行经尿道前列腺右叶切除术,该前列腺右叶已突入膀胱。前列腺组织组织学检查显示为鳞状细胞癌,无腺管和腺泡结构。确诊后评估血清鳞状细胞癌抗原水平(6.2 ng/ml)。胸腹部计算机断层扫描和18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描((18)F-FDG PET/CT)显示前列腺癌并伴有多处淋巴结转移,如右髂外、右髂总、腹主动脉旁和左锁骨上区。患者接受了前列腺外照射治疗,并使用多西他赛进行全身化疗。经过2个疗程的多西他赛治疗后,多处淋巴结转移灶减少,血清鳞状细胞癌抗原水平恢复正常。由于间质性肺炎的副作用,无法继续进行多西他赛治疗。