前立腺類内膜癌の1例

Abstract

尿閉を呈した89歳男で, 血清PSA(前立腺特異抗原)値上昇に拘わらず, 直腸診では良性であった.良性前立腺肥大症の診断で恥骨上前立腺摘除を行った.組織病理学的診断は免疫組織化学的にPSA陽性の前立腺類内膜癌であった.術後, 9ヵ月間エストロゲンを投与した.37ヵ月後, 血清PSA値は上昇し始め, 直腸診で硬結を触れた.生検で類内膜癌と腺癌の共存を認めた.ホルモン療法を再開したところ, 術後65ヵ月間疾患は良く制御された

An 89-year-old man presented with urinary retention. Digital rectal examination was benign despite elevated serum prostate-specific antigen (PSA) level. Suprapubic prostatectomy was performed under the diagnosis of benign prostatic hyperplasia. Histopathological diagnosis was endometrioid carcinoma showing positive immunohistochemical staining for PSA. Postoperatively, estrogen was administered for 9 months. After 37 months, serum PSA level began to increase and a palpable nodule was detected on digital rectal examination. Biopsy showed coexistence of endometrioid carcinoma and acinar adenocarcinoma. Hormonal treatment was resumed and the disease has been well controlled for 65 months postoperatively.