Delay in High-Grade Metastatic Prostate Cancer Progression by Dutasteride : A Case Report

Hinyokika kiyo. Acta urologica Japonica
Yuya YamadaToshio Kanaoka

Abstract

An 84-year-old man was referred to our hospital with swollen right cervical lymph nodes. Computed tomography showed right supraclavicular and mediastinal lymph node enlargement, and fluorodeoxyglucose positronemissiontomography showed multiple areas of abnormally increased radioactivity inthe right supraclavicular and mediastinal lymph nodes, right ninth rib, and left fifth and seventh ribs. Biopsy of the right supraclavicular lymph node revealed metastatic adenocarcinoma with partial immunohistochemical staining for prostate specific antigen (PSA). Serum PSA levels were not elevated (2.01 ng/ml). An 8-core transrectal prostatic biopsy was negative. Thus, we could not determine the primary site of the adenocarcinoma. The patient was diagnosed with carcinoma of an unknown primary site and followed without chemotherapy. Four years later, he was referred to our hospital due to right hydronephrosis. Serum PSA level was 31. 1 ng/ml. The tumor was not palpable by rectal examination. A 12-core transrectal prostatic biopsy revealed a poorly differentiated adenocarcinoma. Computed tomography revealed metastases in the left axilla, para-aortic, and pelvic lymph nodes as well as in the lung. We diagnosed the patient with prostate cancer, ...Continue Reading

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