Wang Hao, Xie Dawei, Lu Jun, Chu Yifan, Wang Siqi, Qiao Peng, Wu Liyang, Wang Jianwen
Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Front Oncol. 2023 Jul 28;13:1211027. doi: 10.3389/fonc.2023.1211027. eCollection 2023.
The aim of this study is to investigate the clinical characteristics and diagnostic and therapeutic methods of bladder metastasis after radical prostatectomy and to improve its diagnosis and treatment.
The clinical data of four patients with bladder metastasis after radical prostatectomy were retrospectively analyzed from January 2011 to December 2021. Three cases suffered from intermittent gross hematuria, and only one case was found to have an elevated prostate-specific antigen (PSA) value. Transurethral resection of bladder tumor was performed in four cases, in which one case also underwent resection of urethral mass. Three cases received endocrine therapy, one of which added intravesical instillation and radiation therapy. Another case received chemotherapy based on comprehensive treatment.
According to the pathological and immunohistochemical results, three cases were acinar adenocarcinoma of the prostate with Gleason score of 9, and all cases were PSA positive and negative for cytokeratin 7 (CK7) and GATA binding protein 3 (GATA-3). One case was small cell neuroendocrine carcinoma of the prostate and was positive for chromogranin A (CGA), synaptophysin (SYN), and cluster of differentiation 56 (CD56). During the follow-up period of 4 to 13 months, one case was lost to follow-up and three cases were alive.
Bladder metastasis after radical prostatectomy is rare, and pathology combined with immunohistochemistry is the gold standard for its diagnosis. Pathological type determines its treatment. Systemic treatment is essential, and local treatment is the most palliative means. Early diagnosis and treatment is significant for better prognosis.
本研究旨在探讨根治性前列腺切除术后膀胱转移的临床特征、诊断及治疗方法，以提高其诊治水平。
回顾性分析2011年1月至2021年12月期间4例根治性前列腺切除术后发生膀胱转移患者的临床资料。3例患者出现间歇性肉眼血尿，仅1例前列腺特异性抗原（PSA）值升高。4例患者均行膀胱肿瘤经尿道切除术，其中1例还切除了尿道肿物。3例患者接受内分泌治疗，其中1例联合膀胱灌注及放疗。另1例在综合治疗基础上接受化疗。
根据病理及免疫组化结果，3例为前列腺腺泡腺癌，Gleason评分9分，所有病例PSA均为阳性，细胞角蛋白7（CK7）及GATA结合蛋白3（GATA-3）均为阴性。1例为前列腺小细胞神经内分泌癌，嗜铬粒蛋白A（CGA）、突触素（SYN）及分化簇56（CD）均为阳性。在4至13个月的随访期内，1例失访，3例存活。
根治性前列腺切除术后膀胱转移罕见，病理联合免疫组化是其诊断的金标准。病理类型决定其治疗方式。全身治疗至关重要，局部治疗是最主要姑息手段。早期诊断和治疗对改善预后具有重要意义。
