初診時より陰茎転移を認めた前立腺癌の1例

Abstract

77歳男.陰茎の硬結を認めたが放置していたところ, 排尿時痛及び夜間頻尿が出現し, PSA高値を指摘された.直腸診及び経直腸超音波検査で膀胱内に突出する前立腺を認め, 検査値も異常高値を示した.経直腸的前立腺生検及び免疫組織化学染色検査と去勢術後の陰茎硬結部の生検により, 前立腺癌の陰茎転移と診断された.術後, 膀胱瘻の留置とジエチルスティルベステロールを追加したが, 硬結及びPSA低下の改善は見られなかった.Estramustine内服とPaclitaxel及びCarboplatin療法を開始したところ, 検査値の低下と硬結の縮小を認めたが, 治療効果の持続なく, 肝転移の出現により癌死した

A 77-year-old man presented with complaints of dysuria, nocturia and painless nodule on his penis. Laboratory examination revealed elevated serum prostate-specific antigen (PSA) and CA19-9. Pathological examinations on prostate and penile biopsy specimens revealed prostate adenocarcinoma with penile metastasis. The patient was diagnosed as having prostate cancer stage D2 (T4N1M1) with bone, lymph node and penile metastases. There was no response to initial hormonal therapy with the surgical castration and diethylstilbestrol. However, decrease of the tumor size, as well as PSA and CA19-9 values were achieved after the combined chemotherapy with Estramustine, Paclitaxel and Carboplatin.