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前列腺癌异时性单发性肺转移:1例罕见病例报告及文献复习

Metachronous Single Pulmonary Metastasis of Prostate Cancer: Report of a Rare Case and Literature Review.

作者信息

Kokkalis Alexandros, Samara Athina A, Papadopoulos Vasileios, Tolia Maria, Tsoukalas Nikolaos, Tsapakidis Konstantinos

机构信息

Department of Medical Oncology, University Hospital of Larissa, Larissa, Greece.

Department of Embryology, Faculty of Medicine, University of Thessaly, Larissa, Greece.

出版信息

Cancer Diagn Progn. 2023 Mar 3;3(2):157-162. doi: 10.21873/cdp.10195. eCollection 2023 Mar-Apr.

Abstract

BACKGROUND

Prostate cancer recurrence after definitive local therapy usually involves the bone and regional lymph nodes.

CASE REPORT

We present the case of a 72-year-old male patient with an isolated lung nodule, seven years after radical prostatectomy for prostate cancer, pT2bN0 and Gleason score 7(4+3), and prostatic-specific antigen (PSA) levels within normal limits. The nodule was considered as a primary lung cancer and the patient was subjected to lobectomy. The immunohistochemical staining showed that the tumor was PSA(+) and NKX3.1 (+), revealing that it was metastasis from prostatic cancer and that wedge resectomy was the proper procedure. Three years later the patient is disease-free, suggesting the importance of aggressive treatment of oligometastatic disease.

CONCLUSION

Metastasis to the lung is present in more than 40% of men with metastatic prostate cancer; however, lung metastases without any bone or lymph node involvement are extremely rare and only a handful of cases are reported in the literature. Surgical excision of the metastatic lung site is the most common therapeutic approach associated with a good prognosis.

摘要

背景

确定性局部治疗后前列腺癌复发通常累及骨骼和区域淋巴结。

病例报告

我们报告一例72岁男性患者,在前列腺癌根治性前列腺切除术后7年出现孤立性肺结节,术前分期为pT2bN0,Gleason评分7(4+3),前列腺特异性抗原(PSA)水平在正常范围内。该结节被认为是原发性肺癌,患者接受了肺叶切除术。免疫组化染色显示肿瘤为PSA(+)和NKX3.1(+),提示为前列腺癌转移,楔形切除术是合适的手术方式。三年后患者无疾病复发,提示积极治疗寡转移疾病的重要性。

结论

在转移性前列腺癌男性患者中,肺转移发生率超过40%;然而,无任何骨骼或淋巴结受累的肺转移极为罕见,文献中仅报道了少数病例。手术切除转移的肺部位是最常见的治疗方法,预后良好。

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