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A case of metastatic prostate adenocarcinoma to an inguinal lymph node.

Komeya M, Sahoda T, Sugiura S, Sawada T, Kitami K - Cent European J Urol (2012)

Bottom Line: A computed tomography scan showed left inguinal lymphadenopathy.Biopsy of the swollen inguinal lymph node revealed metastatic prostate cancer.We report a rare case of metastatic prostate adenocarcinoma only to the inguinal lymph nodes.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Fujisawa City Hospital, Kanagawa, Japan.

ABSTRACT
A 47-year-old man presented with dysuria. The prostate-specific antigen level was 65.5 ng/mL. Retropubic radical prostatectomy and regional lymphadenectomy revealed moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7, pT2N0). Postoperative adjuvant hormonal therapy was started immediately. Three years later, hormonal therapy was changed to anti-androgen monotherapy. Monotherapy was continued for eight years and then discontinued because the PSA level was maintained at <0.04 ng/mL. However, biochemical recurrence occurred 12 months after adjuvant hormonal therapy was discontinued. A computed tomography scan showed left inguinal lymphadenopathy. Biopsy of the swollen inguinal lymph node revealed metastatic prostate cancer. We report a rare case of metastatic prostate adenocarcinoma only to the inguinal lymph nodes.

No MeSH data available.


Related in: MedlinePlus

A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.
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Figure 0002: A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.

Mentions: He was young and was a high-risk patient for recurrence; hence, postoperative adjuvant hormonal therapy (leuproreline and bicalutamide) was started immediately. Three years later, hormonal therapy was changed to monotherapy (bicalutamide). Monotherapy was discontinued because the PSA level was maintained below 0.04 ng/mL for eight years. Two years after the discontinuation, the PSA level increased gradually to 0.73 ng/ml. A CT scan showed no metastasis. He was diagnosed with biochemical recurrence and refused to receive salvage radiotherapy. Complete androgen blockade (leuproreline and bicalutamide) was restarted, and an intensive follow-up was performed every 1 to 1.5 months. Twenty-one months after the biochemical recurrence, the PSA level increased to 10.4 ng/mL and a CT scan showed left inguinal lymphadenopathy (Fig. 2A). The maximum size of the lymph nodes was 2 cm in diameter. To determine whether the lymphadenopathy was caused by metastatic prostate cancer, one of the swollen inguinal lymph nodes was obtained by open biopsy. Pathological findings revealed metastatic prostate cancer (Fig. 1B). The patient was then treated with estramustine phosphate sodium and dexamethasone for 1 year. The size of the lymph node decreased to 8 mm in diameter, and no other metastatic lesions were found (Fig. 2B). The PSA level decreased to 0.2 ng/mL.


A case of metastatic prostate adenocarcinoma to an inguinal lymph node.

Komeya M, Sahoda T, Sugiura S, Sawada T, Kitami K - Cent European J Urol (2012)

A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921775&req=5

Figure 0002: A. (top), A CT scan shows the swollen left inguinal lymph nodes with maximum size of 2cm in diameter. B. (bottom), The maximum size of the lymph nodes decreased to 8 mm in diameter due to secondary hormonal therapy.
Mentions: He was young and was a high-risk patient for recurrence; hence, postoperative adjuvant hormonal therapy (leuproreline and bicalutamide) was started immediately. Three years later, hormonal therapy was changed to monotherapy (bicalutamide). Monotherapy was discontinued because the PSA level was maintained below 0.04 ng/mL for eight years. Two years after the discontinuation, the PSA level increased gradually to 0.73 ng/ml. A CT scan showed no metastasis. He was diagnosed with biochemical recurrence and refused to receive salvage radiotherapy. Complete androgen blockade (leuproreline and bicalutamide) was restarted, and an intensive follow-up was performed every 1 to 1.5 months. Twenty-one months after the biochemical recurrence, the PSA level increased to 10.4 ng/mL and a CT scan showed left inguinal lymphadenopathy (Fig. 2A). The maximum size of the lymph nodes was 2 cm in diameter. To determine whether the lymphadenopathy was caused by metastatic prostate cancer, one of the swollen inguinal lymph nodes was obtained by open biopsy. Pathological findings revealed metastatic prostate cancer (Fig. 1B). The patient was then treated with estramustine phosphate sodium and dexamethasone for 1 year. The size of the lymph node decreased to 8 mm in diameter, and no other metastatic lesions were found (Fig. 2B). The PSA level decreased to 0.2 ng/mL.

Bottom Line: A computed tomography scan showed left inguinal lymphadenopathy.Biopsy of the swollen inguinal lymph node revealed metastatic prostate cancer.We report a rare case of metastatic prostate adenocarcinoma only to the inguinal lymph nodes.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Fujisawa City Hospital, Kanagawa, Japan.

ABSTRACT
A 47-year-old man presented with dysuria. The prostate-specific antigen level was 65.5 ng/mL. Retropubic radical prostatectomy and regional lymphadenectomy revealed moderately differentiated adenocarcinoma (Gleason score 3 + 4 = 7, pT2N0). Postoperative adjuvant hormonal therapy was started immediately. Three years later, hormonal therapy was changed to anti-androgen monotherapy. Monotherapy was continued for eight years and then discontinued because the PSA level was maintained at <0.04 ng/mL. However, biochemical recurrence occurred 12 months after adjuvant hormonal therapy was discontinued. A computed tomography scan showed left inguinal lymphadenopathy. Biopsy of the swollen inguinal lymph node revealed metastatic prostate cancer. We report a rare case of metastatic prostate adenocarcinoma only to the inguinal lymph nodes.

No MeSH data available.


Related in: MedlinePlus