出血性嚢胞を伴った前立腺癌の1例

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68歳男.排尿困難と会陰痛を主訴とし,腹部超音波断層像上前立腺内に径5cmの膿疱性病変を認めたため精査加療目的に入院となった.PSA高値及びMRI所見より,出血性嚢胞を伴った前立腺癌を疑い,膀胱尿道鏡検査,径会陰的嚢胞腺施術を施行した.治療開始後1年が経過した現在,良好な局所コントロールが得られており経過観察中であるA 68-year-old man consulted our department for sudden onset of dysuria and perineal pain. On digital rectal examination, soft and a hen-egg-sized mass was palpated. Serum PSA value was elevated to 11.4 ng/ml. Pelvic magnetic resonance imaging (MRI) suggested a large hemorrhagic cyst associated with prostate cancer. In addition to a pathological diagnosis as poorly differentiated adenocarcinoma (Gleason grade 5/4), which was established by transurethral biopsy, aspirated cyst contents revealed an elevated PSA value (3,090 ng/ml). Clinical staging was determined as T4N0M0. Following administration of androgen-deprivation therapy for 3 months, radiation therapy (64 Gy) was administered to the prostate. Twelve months after the diagnosis, the serum PSA value has remained within normal limits, and no local recurrence of the disease was detected.