University of Health and Allied Sciences, Ho, Ghana.
J Med Case Rep. 2024 May 22;18(1):256. doi: 10.1186/s13256-024-04543-x.
Early diagnosis of prostate cancer is key to achieving a cure and its proper management leads to a good prognosis. In Ghana a large percentage of patients present with advanced disease and unusual presentations in these patients result in greater delay in the diagnosis thus worsening the outcomes.
We present three African males with advanced prostate cancer who had delayed diagnosis. The first patient, a 64 year old male presented with ascites of 2 years duration with weight loss and no lower urinary tract symptoms, the second, a 69 year old man with end stage renal failure of 6 months duration and was receiving dialysis, the third case, an 87 year old man was managed for pulmonary tuberculosis after he presented with chronic cough and lower urinary tract symptoms. All patients eventually had a prostate specific antigen done which were elevated. Further investigations including prostate biopsies, abdominopelvic CT scans for case 1, abdominopelvic ultrasound, prostate biopsies and blood urea and electrolytes for case 2, prostate biopsies, chest and lumbosacral showed a diagnosis of metastatic prostate carcinoma, and all patients were managed with androgen deprivation. The second patient received additional radiotherapy.
A lack of knowledge of prostate cancer symptoms including unusual symptoms, can result in delayed diagnosis especially in regions of the world where a large number of patients present with advanced disease.
早期诊断前列腺癌是实现治愈的关键，而对其进行适当的管理则有助于获得良好的预后。在加纳，很大一部分患者就诊时已处于疾病晚期，这些患者的不典型表现导致诊断延迟，从而导致预后恶化。
我们介绍了 3 位患有晚期前列腺癌的非洲男性，他们的诊断均被延误。第一例患者为 64 岁男性，2 年前出现腹水伴体重减轻，无下尿路症状；第二例为 69 岁男性，患有 6 个月终末期肾衰竭，正在接受透析；第三例为 87 岁男性，因慢性咳嗽和下尿路症状就诊后被诊断为肺结核。所有患者最终均进行了前列腺特异性抗原（PSA）检测，结果升高。进一步的检查包括前列腺活检、第一例患者的腹盆 CT 扫描、第二例患者的腹盆超声、前列腺活检和血尿素氮及电解质检查、第三例患者的胸部和腰骶部 CT 扫描，均诊断为转移性前列腺癌，所有患者均接受雄激素剥夺治疗。第二位患者还接受了额外的放疗。
对前列腺癌症状（包括不典型症状）缺乏认识，可能导致诊断延迟，尤其是在世界上许多患者就诊时已处于疾病晚期的地区。
