Deming Madeleine S
Internal Medicine Consult Service, Clinical Center, National Institutes of Health (NIH), Bethesda, MD, USA.
Am J Case Rep. 2019 Apr 7;20:474-477. doi: 10.12659/AJCR.914152.
BACKGROUND Polymyalgia rheumatica (PMR) is a common rheumatic disease in patients over the age of 50 years. Underlying triggers for PMR are not well understood, but there have been reports of cases presenting prior to the diagnosis of prostate cancer, with one case of PMR presenting following prostatectomy. This report is of a case of PMR that presented following robotic-assisted radical prostatectomy for high-grade prostate cancer and includes a discussion of the possible associations. CASE REPORT A 61-year-old man underwent a robotic-assisted radical prostatectomy for high-grade prostate adenocarcinoma, Gleason grade 4+4=8. The surgical procedure and the patient's postoperative recovery were uneventful, and he was discharged from hospital on the day after surgery. Approximately two weeks later, he developed bilateral symptoms of pain in the groin, thigh, and shoulder girdle. His erythrocyte sedimentation rate (ESR) (30 mm/h) and C-reactive protein (CRP) (16.2 mg/L) levels were raised. A diagnosis of PMR was made and treatment with tapered dosing of methylprednisolone resulted in a 90% improvement in symptoms after four weeks. CONCLUSIONS A case of PMR following robotic-assisted prostatectomy for high-grade prostate carcinoma is presented. To the author's knowledge, this is only the second report of PMR following prostatectomy and the only reported case following robotic-assisted radical prostatectomy.
风湿性多肌痛（PMR）是一种常见于50岁以上患者的风湿性疾病。PMR的潜在触发因素尚不清楚，但有报告称在前列腺癌诊断之前出现过病例，其中一例在前列腺切除术后出现PMR。本报告介绍了一例在机器人辅助根治性前列腺切除术后因高级别前列腺癌而出现的PMR病例，并讨论了可能的关联。病例报告：一名61岁男性因高级别前列腺腺癌（Gleason分级4+4=8）接受了机器人辅助根治性前列腺切除术。手术过程和患者术后恢复顺利，术后第二天出院。大约两周后，他出现了腹股沟、大腿和肩胛带双侧疼痛症状。他的红细胞沉降率（ESR）（30毫米/小时）和C反应蛋白（CRP）（16.2毫克/升）水平升高。诊断为PMR，采用逐渐减量的甲基泼尼松龙治疗，四周后症状改善了90%。结论：本文报告了一例机器人辅助前列腺切除术后因高级别前列腺癌而出现PMR的病例。据作者所知，这是前列腺切除术后PMR的第二例报告，也是机器人辅助根治性前列腺切除术后唯一报告的病例。
