前立腺小細胞癌の1例

Abstract

症例は66歳で, 頻尿と腰痛を主訴とした.直腸診で凹凸不整・板状硬の前立腺を触知し, 超音波検査の所見から前立腺癌を強く疑った.MRIで前立腺周囲脂肪組織や直腸壁への腫瘍浸潤を認め, 腹部CTで傍大動脈から総腸骨動脈に及ぶリンパ節腫脹を認めた.生検により前立腺小細胞癌のTNM分類T4N3M1と診断し, 多剤併用療法を考慮したが, 多発性肝転移と全身状態悪化のため困難と判断した.患者は初診より33日目に急性肝不全のため死亡した

A 66-year-old man was referred to our hospital with a complaint of lumbago. Digital rectal examination showed an enlarged, irregular prostate with stony hardness. The serum level of prostate specific antigen (PSA) was elevated. Abdominal computed tomography showed enlarged common iliac and paraaortic lymph nodes, and multiple liver metastases. Bone scintigraphy showed multiple bone metastases. Histological and immunohistochemical examinations indicated small cell carcinoma and adenocarcinoma of the prostate. Chemotherapy could not be performed due to acute hepatic failure. The patient died 1 month after his first visit.