多発性肺転移を伴った前立腺癌の1例

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A 65-year-old man was hospitalized with bloody sputum. His chest X-ray showed multiple nodules in both lung fields. Transbronchial lung biopsy demonstrated a poorly differentiated adenocarcinoma, which suggested that respiratory abnormalities might be metastatic cancer. Because he had noticed pollakisuria and dysuria, urologic consultation was sought. The findings of digital examination, urethrography, and ultrasonotomography suggested that he had an advanced prostate cancer. In addition, tumor markers of prostatic acid phosphatase (PAP), acid phosphatase (ACP), and prostate antigen (PA) showed abnormal titers; 120 ng/dl, 166 IU/l, and 15.4 ng/ml, respectively. The prostate tissue obtained by transperineal biopsy revealed histopathologically adenocarcinoma and positive findings in immunohistochemical staining for PAP and PA as well as the specimens from the lung. Bilateral orchiectomy and medication of 250 mg of DESD daily as an antiandrogen therapy improved respiratory symptoms. One week after the operation, the multiple shadows on the chest X-ray diminished dramatically. Moreover, serum values of PAP and PA also decreased to the normal range. He is alive in a stable condition 6 months after the operation.