Gossili Farid, Langkilde Niels Christian, Zacho Helle D
Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, 9000 Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
Diagnostics (Basel). 2023 Jul 27;13(15):2509. doi: 10.3390/diagnostics13152509.
A 70-year-old man with high-risk prostate cancer (PCa) received radiation therapy and androgen deprivation therapy (ADT). The patient developed penile tenderness, compatible with Peyronie's disease upon physical examination. An ultrasound revealed a matching hypoechoic plaque and a thrombus in the vena dorsalis profunda, which were treated with anticoagulants. A follow-up ultrasound showed no abnormalities. Despite the use of analgesics, the patient suffered from persistent pain, later accompanied by an increasing PSA level of up to 7.5 ng/mL, despite ADT. Ga-PSMA PET/CT showed a PSMA uptake consistent with PCa penile metastasis. Due to severe pain and the presence of metastatic PCa, the patient was referred for penectomy. Histopathological analysis confirmed metastases originating from the PCa. This case underscores the importance of Ga-PSMA PET/CT in diagnosing PCa metastases and vigilance towards urogenital symptoms as potential indicators of metastases, despite the rarity of penile metastases.
一名患有高危前列腺癌（PCa）的70岁男性接受了放射治疗和雄激素剥夺治疗（ADT）。患者出现阴茎压痛，体格检查发现与佩罗尼氏病相符。超声检查显示有一个匹配的低回声斑块以及阴茎背深静脉内的血栓，对其进行了抗凝治疗。随访超声检查未发现异常。尽管使用了镇痛药，但患者仍持续疼痛，后来尽管接受了ADT治疗，其前列腺特异性抗原（PSA）水平仍不断升高，最高达到7.5 ng/mL。镓-前列腺特异性膜抗原（Ga-PSMA）PET/CT显示PSMA摄取与PCa阴茎转移相符。由于剧痛和转移性PCa的存在，该患者被转诊进行阴茎切除术。组织病理学分析证实转移灶起源于PCa。该病例强调了Ga-PSMA PET/CT在诊断PCa转移中的重要性，以及尽管阴茎转移罕见，但仍需警惕泌尿生殖系统症状作为转移潜在指标的情况。
