Hakamata Yasuhiro, Kanda Yuka, Sugiura Kota, Imai Shin, Yoneda Tatsuaki
The Department of Urology, Seirei Hamamatsu General Hospital.
Nihon Hinyokika Gakkai Zasshi. 2016;107(4):261-265. doi: 10.5980/jpnjurol.107.261.
We report a case of pancreatic metastasis from prostate cancer. A 65 year-old man developed gross hematuria, and was found to have a markedly elevated PSA and abnormal CT findings indicating mass lesions in bilateral lungs, and pancreatic head, and osteoblastic lesions in pelvic bone. He was referred to the department of Urology and Gastroenterology at Seirei Hamamatsu General Hospital. Digital rectal examination revealed a hen's egg-sized, stony-hard prostate. A systematic needle biopsy of the prostate demonstrated adenocarcinoma (Gleason score 4+4=8). We diagnosed multiple lung and bone metastases from prostate cancer, and suspected that a primary pancreatic ductal carcinoma. The patient was started on an androgen deprivation therapy (ADT) with bicalutamide and degarelix. After 4 months from the initiation of ADT, an MRI of the pancreas showed decreased size of the pancreatic head mass from 18 mm to 7 mm in diameter. We concluded that the pancreatic head mass was metastasis from prostate cancer, and currently continue ADT. Pancreatic metastasis from prostate cancer is very rare, and further accumulation of cases will be required.
我们报告一例前列腺癌胰腺转移病例。一名65岁男性出现肉眼血尿,发现前列腺特异性抗原(PSA)显著升高,CT检查结果异常,显示双侧肺部、胰头有肿块,骨盆骨有骨成骨性病变。他被转诊至静冈清水综合医院泌尿外科和胃肠病科。直肠指检发现前列腺有鸡蛋大小、质地坚硬如石。前列腺系统穿刺活检显示为腺癌( Gleason评分4 + 4 = 8)。我们诊断为前列腺癌多发肺转移和骨转移,并怀疑原发性胰腺导管癌。患者开始使用比卡鲁胺和地加瑞克进行雄激素剥夺治疗(ADT)。ADT开始4个月后,胰腺MRI显示胰头肿块直径从18 mm缩小至7 mm。我们得出结论,胰头肿块为前列腺癌转移,目前继续进行ADT。前列腺癌胰腺转移非常罕见,需要进一步积累病例。