Prostate cancer
68,
black M, c/o dysuria, progressively↑ed urinary
freq, back pain x ms. High animal fat intake.
PE:
(digital) nodular, (rock-hard, irregular area of induration in
periph lobe of prostate).
Midline
furrow
b/t prostatic lobes obscured不明.
Extension to seminal vesicle detected.
Markedly↑PSA & acid phosphatase.
Transrectal US-prostate : Hypoechoic masses
in periph zone w/ extension to seminal vesicles.
Nuc-Bone scan: hot lesions of spine, sacrum, &
pelvic bones (axial skeleton).
CT/MR:
prostate mass w/ capsular penetration & enlarged seminal vesicles.
Bx
: (irregular enlarged, firm, nodular) Core Needle Bx-prostate : single
layer of malig cell arranged haphazardly in adenoplastic stroma.
(1∘malig
com arising fr periph zone (70%), mc male cancer.) Px & Tx depend heavily
on stage.
Exhibit
hematogenous spread: Mc to bone (osteoblastic
lesion (bone forming), may also to sacral nerve roots (signif pain))
Tx:
Prostatectomy w/ radiation;
Orchiectomy;
Leuprolide; androgens; flutamide
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