Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Jan 2013)
Prostate Adenocarcinoma with Pelvic and Para-Aortic Lymph Node Metastasis: A Case Report
Abstract
BACKGROUND AND OBJECTIVE: Prostate adenocarcinoma is the most common neoplasm in men. The most common metastatic sites are usually bones, lung and pelvic lymph nodes. The sensitivity and reliability of detection of lymph node metastases from prostate cancer is important.CASE: The patient was a 65 year old male who referred with three month weight loss (approximately 15 kg), abdominal pain, and inflammation and pain of right testis associated with difficulty in voiding. In physical examination, right inguinal lymph nodes are palpable. Kidney and liver function test was normal, and prostate- specific antigen was reported 10.2ng/ml. In abdominal and pelvic sonography and CT scan, right pelvic masses and paraaortic lymph nodes were observed. In digital rectal examination, prostate consistency was normal. The patient underwent transrectal ultrasound guided prostate biopsy that the prostate adenocarcinoma with Gleason score of 10 was reported. Oncology consultation is given due to unusual CT findings, high Gleason score, severe weight loss and abdominal lymphadenopathy. Then different treatments are suggested to the patient and finally he had bilateral orchidectomy. One month after orchidectomy, intraabdominal masses were obliterated and abdominal signs were reduced. Meanwhile, prostate-specific antigen was 0.34 ng/ml. The patients weight increased to about 5 kg, and after a 6 month follow up his general condition was good.CONCLUSION: Old patients with weight loss, weakness and abdominal lymph nodes need careful clinical assessment especially for prostate cancer.
