前立腺Endometrioid adenocarcinomaの3例

Abstract

前立腺Endometrioid adenocarcinomaの3例を経験した.症例1(71歳男性).排尿困難で受診.肉眼的血尿, PSA上昇, 膀胱尿道鏡で前立腺右葉より尿道へ突出する乳頭上腫瘍を認め, 生検で類内膜腺癌と診断, TAB療法でPSAは低下し, 前立腺全摘除術を行った.しかし約1年3ヵ月後, 排尿困難から膀胱鏡で乳頭状腫瘍を認めて切除, 類内膜腺癌であった.症例2(71歳男性).肉眼的血尿, 膀胱タンポナーデで入院となった.PSA高値, CT・MRIで前立腺左葉より膀胱内に突出し, 精嚢へ浸潤する腫瘍を認め, 生検で前立腺類内膜腺癌と診断, 膀胱前立腺摘除術を施行した.3ヵ月後PSA高値より, CTで多発性肝転移を認め, TAB療法でPSAは低下した.症例3(86歳男性).高血圧, 高脂血症で他院通院中, PSA高値で紹介入院となった.MRIで前立腺両葉に内腺への浸潤を疑うlow intensity areaを認め, 生検で類内膜腺癌と診断, TAB療法でPSAは低下した

We report three cases of endometrioid adenocarcinoma of the prostate. Case 1: A 71-year-old male was admitted with a complaint of micturition pain. Serum prostatic specific antigen (PSA) was 12 ng/ml. Radical prostatectomy following needle biopsy was performed in May 1998. Histopathological diagnosis was prostatic endometrioid adenocarcinoma (pT2bpN0M0). Case 2: A 71-year-old male was admitted with a complaint of macrohematuria. PSA was 18 ng/ml. Cystoprostatectomy and ileal conduit construction following needle biopsy were performed in July 2002. The tumor that was diagnosed as endometrioid adenocarcinoma, invaded the bladder neck (pT4pN0M0). Case 3: An 86-year-old male was referred to our department for elevated PSA (16.8 ng/ml). Prostatic needle biopsy was performed and histopathological diagnosis was endometrioid adenocarcinoma with a part of well differentiated adenocarcinoma (T2bN0M0). PSA dropped to an undetectable range after total androgen blockade therapy.