Okamoto T, Ogiu K, Sato M, Kaneko T, Suzuki Y, Tanji S, Fujioka T
Department of Urology, Iwate Medical University, Japan.
Hinyokika Kiyo. 1996 Jan;42(1):67-70.
The patient was a 77-year-old man who visited our clinic with a chief complaint of dysuria. Digital rectal examination suggested prostatic carcinoma, but prostatic tumor marker levels were within normal limits. Transrectal needle biopsy was performed and histology was squamous cell carcinoma. Radical prostatectomy and pelvic lymph node dissection were performed with the diagnosis of T3N0M0 primary squamous cell carcinoma of the prostate. The 127 gm. tumor was moderately differentiated pT3N2M0 squamous cell carcinoma. Metastasis to the bilateral internal iliac arterial lymph nodes was confirmed histologically. Therefore, four courses of chemotherapy were performed using methotrexate, cisplatin, and pepleomycin. However, local recurrence was observed 11 months postoperatively and multiple pulmonary metastasis was developed at 13 months. The patient died of the disease 14 months after the operation. In Japan, seven cases of primary squamous cell carcinoma of the prostate have been reported, but none of these patients were treated by radical prostatectomy when the diagnosis was established by preoperative biopsy. In this case, changes in the squamous cell carcinoma antigen level in the blood corresponded to the effect of postoperative chemotherapy.
患者为一名77岁男性，因排尿困难为主诉前来我院就诊。直肠指检提示前列腺癌，但前列腺肿瘤标志物水平在正常范围内。行经直肠穿刺活检，组织学检查为鳞状细胞癌。诊断为前列腺原发性鳞状细胞癌T3N0M0后，行根治性前列腺切除术及盆腔淋巴结清扫术。127克肿瘤为中度分化的pT3N2M0鳞状细胞癌。组织学证实双侧髂内动脉淋巴结转移。因此，使用甲氨蝶呤、顺铂和博来霉素进行了四个疗程的化疗。然而，术后11个月观察到局部复发，13个月时出现多发肺转移。患者术后14个月死于该疾病。在日本，已报道7例前列腺原发性鳞状细胞癌病例，但在术前活检确诊时，这些患者均未接受根治性前列腺切除术治疗。在本病例中，血液中鳞状细胞癌抗原水平的变化与术后化疗效果相对应。
