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Title: 内分泌療法が奏効した巨大前立腺癌の1例
Other Titles: Giant prostate carcinoma treated effectively with endocrine therapy: case report
Authors: 増栄, 成泰  KAKEN_name
長谷川, 義和  KAKEN_name
Author's alias: Masue, Naruyasu
Hasegawa, Yoshikazu
Keywords: Giant prostate carcinoma
Endocrine therapy
Issue Date: Feb-2007
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 53
Issue: 2
Start page: 133
End page: 135
Abstract: 86歳男。尿閉を来たし, 下腹部に巨大腫瘤を指摘された。CT・MRIで前立腺から連続性のある巨大腫瘤を認め, 大きさは14.1×10.3×14.0cmであった。検査所見で血清PSA値は960ng/mlと高値で, 経皮的針生検を施行したところ, すべての検体から中分化型前立腺癌を認め, Gleason scoreは4+4であった。他臓器に異常所見は認めず, 原発性前立腺癌, T4N0M0, TNM分類stage IVと診断し, Goserelin acetate 3.5mg/月とBicalutamide 80mg/日併用のCombined androgen blockade(CAB)療法を開始した。トランスアミナーゼの上昇でBicalutamideを中止してグルタチオンの内服を行い, トランスアミナーゼ正常化後はChlormadinone acetate 100mg/日に変更してCAB療法を継続したが, 副作用は認めなかった。その後Naftopidil 50mg/日の内服を開始し, 自立排尿が可能となったため退院した。血清PSAは治療開始1ヵ月後に57ng/ml, 3ヵ月後には0.6ng/mlとなり, CT上腫瘤は著明に縮小した。1年経過して再燃はない。
An 87-year-old man visited our hospital, complaining of abdominal distention and inability to urinate. Computed tomography (CT) and magnetic resonance imaging revealed a giant prostate tumor. The patient underwent percutaneous tumor biopsies. The histologic diagnosis was moderately differentiated adenocarcinoma of prostate. The clinical stage according to the TNM classification system was T4N0M0, stage IV. Combined androgen blockade therapy was performed. Four months later, CT showed that the tumor had decreased markedly in size, and the serum prostate specific antigen level was within normal range. Hormone refractory prostate cancer was not found 1 year after the start of treatment.
PubMed ID: 17352166
Appears in Collections:Vol.53 No.2

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