脳転移をきたした前立腺癌の1例

Abstract

82歳男.前立腺特異抗原(PSA)が高値のため精査を行い前立腺癌(中分化型腺癌)と診断した.このとき腹部・胸部CTおよび頭部CTにおいて明らかな転移所見は認められず, 病期分類T3aN0M0とした.LH-RH analogueによる去勢療法を開始し, PSAは順調に低下していたが, 7ヵ月後に突然左側の上下肢脱力感を訴え, 頭部CT・MRI所見から多発性脳転移と診断した.転移巣に対して放射線治療を行ったがADLの改善は得られず, 前立腺癌の診断から1年1ヵ月後に呼吸不全のため死亡した

A 82-year male consulted us for elevation of prostate specific antigen, diagnosed as prostatic adenocarcinoma (moderated differentiated). We decided to observe him under androgen deprivation therapy. During the 8 months of treatment, left hemi-paresis started to appear. Brain magnetic resonance imaging revealed the multiple brain metastases, suspected to have originated from the prostate cancer. Total 30 Gy radiotherapy could not establish the improvement of activity of daily living. We discuss the cases of brain metastasis associated with prostate cancer.