Prostate cancer associated with long-term intake of patent medicine containing methyltestosterone: a case report

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81歳男.腰痛と頻尿を主訴に入院し,前立腺癌stage D2(T3N2M1)と診断された.血清PSAは3,560ng/mlと著しく高値であったが,血清テストステロンは55.6ng/dl,LHは0.8mIU/mlと著しく低値であった.患者の詳細な問診により,6～9mgのメチルテストステロンを含む内服薬を毎日30年間にわたり服用していたことが判明した.その内服を厳禁し,酢酸クロルマジノンの内服と両側精巣摘除術を施行した.その後7ヵ月間,前立腺癌のコントロールは良好であるAn 81-year-old man, admitted with lumbago and pollakisuria, was diagnosed to have stage D2 prostate cancer (T3N2M1). Although the serum level of prostate specific antigen (PSA) was 3,560 ng/ml, serum testosterone (55.6 ng/dl) and luteinizing hormone (LH, 0.8 mIU/ml) levels were very low. Detailed inquiry of the patient revealed a daily intake of patent medicine containing 6-9 mg methyltestosterone for the past 30 years. He was treated by surgical castration and oral chlormadinone acetate. We advised him not to take such androgenic drugs. The disease has been well controlled for 7 months. We stress the importance of checking medication habits of patients with prostate cancer, especially androgen-containing drugs which can be purchased without a physician's prescription. A low serum LH level may be an important finding indicating the intake of androgenic drugs.