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[Renal metastasis from prostatic adenocarcinoma : a case report].
Sakata, R, Iwasaki, A, Kobayashi, M, Osaka, K, Fujikawa, A, Tsuchiya, F, Ishizuka, E
Hinyokika kiyo. Acta urologica Japonica. 2011;(12):683-7
Abstract
We report a case of renal metastases from prostate cancer to show that the possibility of tumor metastasis, although rare, should be considered in the differential diagnosis of renal mass. A 67-year-old man was found to have a renal mass on computed tomographic scan incidentally. He had had total androgen blockage (bicalutamide + leuprolerin) and chemotherapy (docetaxel hydrate ) for treatment of prostate cancer discovered 33 months ago. On the basis of the clinical features and radiologic results, the patient was thought to have a second malignant tumor, and we performed left nephrectomy. The pathological finding of this case was renal metastasis from prostatic adenocarcinoma. He died 18 months postnephrectomy.
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2.
[Carcinomatous meningitis from prostate cancer diagnosed by cerebrospinal fluid cytology and magnetic resonance image: a case report and review of the literature].
Yasufuku, T, Shigemura, K, Tanaka, H, Matsumoto, O, Nakano, Y, Tanaka, K, Fujisawa, M
Hinyokika kiyo. Acta urologica Japonica. 2009;(6):361-5
Abstract
A 55-year-old man was treated with 10 courses of intermittent Paclitaxel, estramustine phosphate sodium and carboplatin (PEC) chemotherapy for hormone-refractory prostate cancer. He was admitted to our department with a complaint of severe headache 2 years after initiating chemotherapy. Enhanced computed tomography (CT) of the brain demonstrated no obvious lesion, but a brain dynamic magnetic resonance image (MRI) showed a diffusely enhanced lesion on the surface of the brain. Cerebrospinal fluid cytology revealed adenocarcinoma cells; and therefore it was diagnosed as carcinomatous meningitis metastasized from prostate cancer. After glycerin and betamethasone were used to control brain edema, the patient's headache temporarily improved. However, he died on the 36th day after admission in the natural course of the disease after he and his family selected not to undertake further active treatment. To our knowledge, only 6 cases of carcinomatous meningitis associated with prostate cancer have been reported in Japan. It is generally difficult to diagnose carcinomatous meningitis because the symptoms vary considerably. Once diagnosed, active treatment is not undertaken in most cases since the patient cannot tolerate further treatment. The prognoses for patients with advanced prostate cancer and metastatic carcinomatous meningitis are generally quite poor. Early diagnosis and prompt initiation of therapy could improve the quality of life for such patients. In this case study, MRI was superior to CT for imaging a metastatic carcinomatous meningitis lesion.
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3.
Rectal fistulas after prostate brachytherapy.
Tran, A, Wallner, K, Merrick, G, Seeberger, J, Armstrong, J, Mueller, A, Cavanagh, W, Lin, D, Butler, W
International journal of radiation oncology, biology, physics. 2005;(1):150-4
Abstract
PURPOSE To compare the rectal and prostatic radiation doses for a prospective series of 503 patients, 44 of whom developed persistent rectal bleeding, and 2 of whom developed rectal-prostatic fistulas. METHODS AND MATERIALS The 503 patients were randomized and treated by implantation with 125I vs. 103Pd alone (n = 290) or to 103Pd with 20 Gy vs. 44 Gy supplemental external beam radiotherapy (n = 213) and treated at the Puget Sound Veterans Affairs Medical Center (n = 227), Schiffler Cancer Center (n = 242) or University of Washington (n = 34). Patients were treated between September 1998 and October 2001 and had a minimum of 24 months of follow-up. The patient groups were treated concurrently. Treatment-related morbidity was monitored by mailed questionnaires, using standard American Urological Association and Radiation Therapy Oncology Group criteria, at 1, 3, 6, 12, 18, and 24 months. Patients who reported Grade 1 or greater Radiation Therapy Oncology Group rectal morbidity were interviewed by telephone to clarify details regarding their rectal bleeding. Those who reported persistent bleeding, lasting for >1 month were included as having Grade 2 toxicity. Three of the patients with rectal bleeding required a colostomy, two of whom developed a fistula. No patient was lost to follow-up. The rectal doses were defined as the rectal volume in cubic centimeters that received >50%, 100%, 200%, or 300% of the prescription dose. The rectum was considered as a solid structure defined by the outer wall, without attempting to differentiate the inner wall or contents. RESULTS Persistent rectal bleeding occurred in 44 of the 502 patients, 32 of whom (73%) underwent confirmatory endoscopy. In univariate analysis, multiple parameters were associated with late rectal bleeding, including all rectal brachytherapy indexes. In multivariate analysis, however, only the rectal volume that received >100% of the dose was significantly predictive of bleeding. Rectal fistulas occurred in 2 patients (0.4%), both of whom had received moderate rectal radiation doses and extensive intervention for rectal bleeding. CONCLUSION Partly on the basis of data from others and data presented here, we believe that the incidence of rectal fistulas can be much lower than in our series. High rectal radiation doses should be avoided a priori, to minimize the likelihood of rectal bleeding, and hence the likelihood that invasive procedures will be performed.
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4.
Malignant perivascular epithelioid cell tumor involving the prostate.
Pan, CC, Yang, AH, Chiang, H
Archives of pathology & laboratory medicine. 2003;(2):E96-8
Abstract
Perivascular epithelioid cell tumor (PEComa) is a neoplasm chiefly composed of HMB-45-positive epithelioid cells with clear-to-granular cytoplasm and a perivascular distribution. We describe such a tumor involving the prostate and seminal vesicle in a 46-year-old man. The tumor had characteristic histologic features of PEComa. Immunohistochemically, the tumor cells were positive for HMB-45 but negative for epithelial markers, Melan-A, and S100 protein. The tumor behaved in a malignant fashion, and the patient died of the disease 4 years after diagnosis.
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5.
Disseminated intravascular coagulation and PC-SPES: a case report and literature review.
Lock, M, Loblaw, DA, Choo, R, Imrie, K
The Canadian journal of urology. 2001;(4):1326-9
Abstract
BACKGROUND PC-SPES is a herbal remedy gaining acceptance amongst prostate cancer patients and health care providers due to credible laboratory and clinical studies. However, PC-SPES has not been assessed in the standard rigorous approval process mandated for conventional agents. OBJECTIVES To present a case of a patient with prostate cancer who, while using PC-SPES, developed disseminated intravascular coagulation (DIC). A review of the literature was conducted to determine if there is a relationship between PC-SPES and hemorrhagic disorders. METHODS Searches were conducted in MEDLINE (1966-December 2000) and the Cochrane Collaboration's database. RESULTS There are 116 clinical and laboratory based studies of PC-SPES published to date. There are no randomized controlled trials. Clinical studies have demonstrated a significant reduction in prostate specific antigen (PSA) levels within 6 weeks. Improved quality-of-life, reduction in the volume of tumor deposits and reduction in analgesic use has been demonstrated in hormone refractory patients. Laboratory studies suggest that the beneficial effects of PC-SPES are unrelated to physiologic estrogens. However, PC-SPES has a side-effect profile similar to diethylstilbestrol. There is data demonstrating a <5% risk of thromboembolic events, but this is the first report of DIC. CONCLUSION The study of PC-SPES is in its infancy. This case may serve as a cautionary note to health care providers and patients regarding herbal remedies. Those using PC-SPES should have an increased level of surveillance for bleeding disorders.
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6.
Rectourethral fistula and massive rectal bleeding from iodine-125 prostate brachytherapy: a case report.
Cherr, GS, Hall, C, Pineau, BC, Waters, GS
The American surgeon. 2001;(2):131-4
Abstract
Iodine-125 brachytherapy is an effective well-tolerated treatment for localized prostate cancer. Gastrointestinal complications of brachytherapy (minor rectal bleeding or tenesmus) are uncommon. Rectal ulceration or rectourethral fistulas after prostate brachytherapy are rare. We present a case of massive refractory rectal bleeding and rectourethral fistula, a complication of prostate brachytherapy never before reported. As a result of the patient's life-threatening symptoms aggressive surgical therapy was necessary.
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7.
Ketoconazole and Flutamide in the treatment of disseminated intravascular clotting from prostate cancer: a case report and review.
Chakrapee-Sirisuk, S, Amornpichetkul, K, Visudhiphan, S, Sangruchi, T, Srimuninnimit, V, Sinlarat, P
Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 2001;(10):1495-501
Abstract
Disseminated intravascular clotting (DIC) is a well-recognized complication of malignancy. Prostatic cancer can produce chronic DIC as well as acute severe DIC. Treatment of DIC are general supportive measures including heparin, transfusion of blood, platelets and clotting factors, but the most important aspect is correction of underlying malignant diseases i.e. cancer of the prostate gland. For metastatic prostatic cancer presenting with an emergency oncologic condition, the treatment of choice is surgical orchiectomy, but surgery may not be possible in the presence of severe DIC. Ketoconazole and Flutamide are drugs with different mechanisms for hormonal manipulation of this cancer. Due to severe DIC, we combined both drugs trying to put maximum therapeutic effect on this life threatening profound DIC patient.
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8.
Does drinking carrot juice affect cancer of the prostate?
Del Mar, CB, Glasziou, PP, Spinks, AB, Sanders, SL
The Medical journal of Australia. 2001;(4):197
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9.
[Step up therapy].
Shiono, A, Kurokawa, K, Ito, K, Yamanaka, H
Nihon rinsho. Japanese journal of clinical medicine. 2000;:292-4
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10.
[Treatment of hormone-refractory prostate cancer with etoposide (Vp16)].
Nagayama, T, Maruoka, M
Nihon rinsho. Japanese journal of clinical medicine. 2000;:340-2