[一例前列腺癌输尿管转移病例]

[A Case of Ureteral Metastasis from Prostate Cancer].

作者信息

Matsukawa Atsuki, Shimizu Yosuke, Uketa Shoko, Ogawa Kosuke, Utsunomiya Noriaki, Katsushima Hiroki, Asai Satsuki, Ishihara Misa, Hashimoto Kimio, Kanamaru Sojun

机构信息

The Department of Urology, Kobe City Nishi-Kobe Medical Center; The Departments of Urology, Osaka University Graduate School of Medicine.

The Department of Urology, Kobe City Nishi-Kobe Medical Center.

出版信息

Hinyokika Kiyo. 2021 Apr;67(4):171-176. doi: 10.14989/ActaUrolJap_67_4_171.

DOI:10.14989/ActaUrolJap_67_4_171

PMID:34107615

Abstract

Ureteral metastasis from prostate cancer is rare. The present case report describes an 83-year-old patient with distant metastasis of prostate cancer to the right ureter that caused hydronephrosis. Upon initial examination at our hospital, he presented with a high prostate-specific antigen (PSA) level of 10.0 ng/ml. He was diagnosed with prostate adenocarcinoma, with Gleason score of 10 (5＋5) and clinical staging of cT2aN0M0. Intensity-modulated radiation therapy (IMRT) was performed after 1 year and 7 months of androgen depriation therapy. At 1 year and 4 months after IMRT, PSA increased to 3.068 ng/ml. Computed tomography scan revealed right hydronephrosis and thickening of the right ureter. We could not identify obvious malignant cells on ureteroscopic biopsy, and right nephroureterectomy was performed. Pathological examination revealed ureteral metastasis of prostate cancer. Six months after nephroureterectomy, PSA increased to 3.037 ng/ml. He was diagnosed with castration-resistant prostate cancer and has been treated with enzalutamide.

摘要

前列腺癌发生输尿管转移较为罕见。本病例报告描述了一名83岁的患者，其前列腺癌发生远处转移至右侧输尿管，导致肾积水。在我院初诊时，他的前列腺特异性抗原（PSA）水平较高，为10.0 ng/ml。他被诊断为前列腺腺癌，Gleason评分为10（5＋5），临床分期为cT2aN0M0。在进行1年7个月的雄激素剥夺治疗后，实施了调强放射治疗（IMRT）。IMRT后1年4个月，PSA升至3.068 ng/ml。计算机断层扫描显示右侧肾积水及右侧输尿管增厚。输尿管镜活检未发现明显恶性细胞，遂行右侧肾输尿管切除术。病理检查显示为前列腺癌输尿管转移。肾输尿管切除术后6个月，PSA升至3.037 ng/ml。他被诊断为去势抵抗性前列腺癌，目前正在接受恩杂鲁胺治疗。