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[一例伴继发性性腺功能减退的前列腺癌病例]

[A CASE OF PROSTATE CANCER WITH SECONDARY HYPOGONADISM].

作者信息

Tomiyama Eisuke, Nagahara Akira, Nakano Kosuke, Nakazawa Shigeaki, Uemura Motohide, Kiuchi Hiroshi, Imamura Ryoichi, Miyagawa Yasushi, Minato Noriko, Koga Minoru, Sugao Hideki, Nonomura Norio

机构信息

Department of Urology, Osaka University Graduate School of Medicine.

Department of Urology, Minoh City Hospital.

出版信息

Nihon Hinyokika Gakkai Zasshi. 2017;108(4):215-219. doi: 10.5980/jpnjurol.108.215.

Abstract

A 70 year-old man underwent contrast CT, which revealed his swollen left inguinal and pelvic lymph nodes. The lymph nodes reduced in size without any treatments in a follow-up examination. In 2013, the lymph nodes enlarged again, and FDG-PET/CT showed high value at the prostate and multiple lymph nodes. The levels of serum PSA was high (PSA=682 ng/ml), therefore he underwent a prostate biopsy in his previous hospital and was diagnosed prostate cancer with metastasis of lymph nodes (cT2cN1M1a). Androgen deprivation therapy (ADT) was administered; however, the levels of serum PSA didn't reduce and lymph nodes enlarged further. He was referred to our hospital for further evaluation and treatment. The levels of serum total testosterone before ADT administration at his previous hospital was less than 0.05 ng/ml, which meaned that he had been hypogonadism. Brain MRI revealed a pituitary tumor, and he was diagnosed secondary hypogonadism due to the pituitary tumor. This was thought a rare case of a prostate cancer with secondary hypogonadism which had become castration resistant at the time of diagnosis.

摘要

一名70岁男性接受了增强CT检查,结果显示其左侧腹股沟和盆腔淋巴结肿大。在后续检查中,这些淋巴结未经任何治疗便缩小了。2013年,淋巴结再次肿大,氟代脱氧葡萄糖正电子发射断层扫描/CT显示前列腺和多个淋巴结有高代谢值。血清前列腺特异抗原(PSA)水平很高(PSA = 682 ng/ml),因此他在之前的医院接受了前列腺活检,被诊断为前列腺癌伴淋巴结转移(cT2cN1M1a)。给予了雄激素剥夺治疗(ADT);然而,血清PSA水平并未降低,淋巴结进一步肿大。他被转诊至我院进行进一步评估和治疗。他在之前医院接受ADT治疗前血清总睾酮水平低于0.05 ng/ml,这意味着他存在性腺功能减退。脑部MRI显示有垂体瘤,他被诊断为继发于垂体瘤的继发性性腺功能减退。这被认为是一例罕见的前列腺癌病例,在诊断时已出现继发性性腺功能减退且对去势治疗耐药。

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