多発性肺転移が発見の契機となりComplete androgen blockade(CAB)療法が奏効した前立腺癌の1例

Abstract

73歳男.胸部X線検査と, PSA値の異常を契機に発見された多発性肺転移巣を有する前立腺癌を経験した.CAB療法を行い, 奏効した.また, 胸部X線検査異常を前立腺癌発見の契機とした, 肺転移を有する本邦報告26症例を集計して, それらの特徴と初回治療法の重要性, ならびにその選択について考案を加えた

Prostatic cancer is rarely diagnosed by detection of lung metastases. We report a case of prostatic cancer in a 73-year-old man detected by abnormalities in chest X-ray and serum prostate specific antigen (PSA) level. He was initially admitted to our hospital due to elevation of PSA level. On the first transperineal prostatic needle biopsy, prostatic cancer was not detected and he was followed. Seven months after the first biopsy, chest X-ray revealed multiple abnormal nodules in the lung fields bilaterally and PSA level was again elevated. A second prostatic biopsy and whole-body examination were performed, and he was diagnosed with moderately differentiated prostatic adenocarcinoma with multiple lung metastases. Complete androgen blockade therapy was performed immediately. Two months after the beginning of treatment, PSA level was normalized and the multiple lung metastases had completely disappeared. There has been no evidence of recurrence or PSA relapse 24 months after detection of the prostatic cancer. This is the 26th case of prostatic cancer diagnosed in Japan following detection of multiple lung metastases.