Testicular metastasis of prostatic adenocarcinoma: report of 2 cases

Prostatic carcinoma metastasizing to the testis is an extremely rare occurrence. In this study, two new cases have been reported of unilateral testicular metastases from an adenocarcinoma of the prostate. Unlike primary tumors of the testis, this type of tumor develops later in life (between 50 and 60 years of age), and is in most instances unilateral. It is generally discovered accidentally during orchiectomy or autopsy. It is not always easy to establish a morphological diagnosis, as the macroscopic appearance of the tumor may be normal. However, microscopic investigation reveals the presence of neoplasms of the testis.     

Surgical therapy in lung cancer with single brain metastasis

From January 1975 to April 1987, 27 patients underwent surgical resection of non oat cell lung cancer and a single brain metastasis. There were 25 men and 2 women ranging in age from 37 to 70 years. In 21 cases the brain metastasis was synchronous while in 6 cases the onset was metachronous. In 17 cases, the site of the brain metastasis was supratentorial and in 10 cases it was located in the posterior fossa. The chest X-ray confirmed the primary lung tumour in 24 cases. In 3 cases, only bronchoscopy and cytology revealed the primary focus of the tumour. The lung cancer was located in the upper lobe in 25 patients. Upper lobectomy was performed in 23 patients, pneumonectomy in 3, and lower lobectomy in 1. There were no operative deaths. The cell type was adenocarcinoma in 19 cases, squamous cell carcinoma in 4 patients and large cell carcinoma in 4. Only the tumour and nodes were used for staging at thoracotomy. The classification was: 12 patients in stage I, 2 in stage II, and 13 in stage III. At conclusion of the study the longest survival was 68 months after thoracotomy. There was no significant difference in the duration of survival in patients over or under 50 years old. Better results were obtained in patients without node metastases at thoracotomy (median survival of 30 months and an overall 5-year survival of 35%), and in patients with supratentorial metastases (median survival of 22 months and an overall 5-year survival of 23.4%). Our experience confirms that combined surgery prolongs survival and improves the quality of life.     

Intermittent intravenous high-dose cyclophosphamide therapy for advanced prostatic cancer with distant metastasis

Twelve patients with advanced carcinoma of the prostate were treated with intravenous high-dose cyclophosphamide. All were hormone-resistant cases. At an interval of 3-4 weeks, cyclophosphamide was administered intravenously. The standard dosage of cyclophosphamide was 1,000 mg/m2 and a 10% lower dose was administered to patients with liver dysfunction, anemia and elderly patients. The results of 10 patients were evaluable. One case showed objective partial response, 1 case was stable and 8 patients showed objective progression according to the NPCP efficacy evaluation standard. The overall response rate was 20%, which we did not consider satisfactory. As to toxicity of cyclophosphamide, one patient died of severe acute hepatic failure, but in others, complications were mild to tolerable.     

Effect of hormone therapy on immune response in patients with prostatic cancer

Thirty-one patients with adenocarcinoma of the prostate had laboratory studies done for total proteins, serum immunoglobulins, white blood cell counts, lymphocyte blastogenesis, skin tests, acid phosphatase, and CEA (carcinoembryonic antigen). The 16 patients receiving no hormones had depressed total proteins, lymphocyte and monocyte counts, skin tests, and CEA compared with the 15 patients receiving hromones who had depressed serum immunoglobulins, white blood cell counts, lymphocyte blastogenesis, and acid phosphatase.     

Intracranial metastasis in prostatic cancer

The intracranial metastasis due to prostatic adenocarcinoma are quite rare, inside them, the ones placed in the parasellar region on the cranial base are exceptional. There are only 3 clinical cases found in the literature consulted, now we report here two more cases and we review the etiopathogenia, clinic presentation, diagnosis and treatment for this type of lesions. Usually there are very undifferentiated neoplasms, developed stages and with multiple metastasis at others levels. A patient with prostatic carcinoma known and neurological signs we should suspect the presence of intracranial metastasis. The diagnosis is made with image tests (basically with CT and MRI), being necessary in some cases the histological confirmation with a biopsy. Although the prognostic of these patients (less than 6 months in our cases) depends more of the evolutive stage of the illness than the type of treatment that the patients will be someated, we should establish it rapidly, on this way we can revert the neurological status and we will improve the quality of life of these patients.     

Ureteral metastasis of a prostatic cancer

The authors report the case of a patient treated medically for prostatic cancer, who presented with a ureteric metastasis suggestive of a tumour of the excretory tract. Histological examination revealed that this lesion was actually a suspended metastasis of prostatic cancer.     

Surgical treatment of lung metastasis: experience with 108 cases

In this study the Author's analyze their experience (between September 1973 and December 2002) with 108 pulmonary resections for metastatic tumors to the lungs to evaluate prognostic factors and the impact on survival of extended metastasectomy. Overall mortality and major morbidity were 1.85% and 2.78%. The actuarial survivals at 5 and 10 years were respectively 46.6% and 39.9%. The best mean survivals are observed in patients with metastases from breast, colorectal, thyroid and urinary tract carcinomas, in cases with disease free interval > 12 months and in the patients who underwent sequentially surgery and chemotherapy. Patients with pulmonary metastases also potentially benefit from iterative pulmonary resection.     

四联疗法治疗肺癌骨转移1例

1病历摘要患者男,57岁,2008年8月因．咳嗽、痰中带血、右侧胸痛行胸部CT检查诊断右下肺癌,行右下肺叶切除＋纵隔淋巴结清扫术．术后病理示分化差的神经内分泌癌,较符合大细胞未分化癌。给予化疗三周期（方案不详）,08年12月查ECT示：L5、左第5、10后肋、右第5～8肋骨多发转移．患者未诉骨痛;09年2月入我院治疗,入院查体：     

~(153)Sm EDTMP combined with endocrine therapy for treatment of prostatic cancer bone metastasis

~(153)Sm EDTMP combined with endocrine therapy for treatment of prostatic cancer bone metastasis     

The correlation between pretreatment serum hormone levels and treatment outcome for patients with prostatic cancer and bony metastasis

OBJECTIVE: To evaluate whether pretreatment serum hormone levels are a prognostic factor for prostatic cancer with bony metastasis under hormonal treatment. PATIENTS AND METHODS: Between 1980 and 1994, 96 patients with prostate cancer and bony metastasis were included for an evaluation by a retrospective review of their charts. All 96 had received hormonal treatment after a diagnosis of metastatic prostatic carcinoma. Serum testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were assessed before treatment. The patients were divided into two groups according to their response during the follow-up. Group 1 (good response) had no change or resolution of metastatic lesion(s) on the bone scan and a declining prostate-specific antigen (PSA) level. Group 2 had increased PSA or progression of metastatic lesion(s) on the bone scan. Tumours were graded as low (2-4), intermediate (5-7) and high (8-10) using the Gleason score. RESULTS: There were 43 patients in group 1 and 53 in group 2; the overall mean (sd) age was 72.5 (6.8) years and the follow-up 29.5 (0.5) months. The respective mean (sd) levels of testosterone, LH, FSH and prolactin before treatment were 4.6 (1.6) ng/mL, 20.2 (13.3) mIU/mL, 19.6 (18.6) mIU/mL and 20.7 (12.1) ng/mL in group 1, and 2.6 (1.0) ng/mL, 27.3 (11.0) mIU/mL, 27.1 (9.8) mIU/mL and 41.3 (28.4) ng/mL in group 2. The level of testosterone was significantly higher in group 1 than in group 2, while LH, FSH and prolactin were significantly lower in group 1 than in group 2. When stratified by tumour grade, patients in group 1 still had significantly higher pretreatment testosterone and lower LH, FSH and prolactin than those in group 2. CONCLUSION: Higher testosterone and lower LH, FSH and prolactin levels were good prognostic factors for patients with metastatic prostatic cancer under hormonal treatment, irrespective of tumour grading.     

黄体生成素释放激素-A治疗前列腺癌去势后复发转移九例报告

目的　评估黄体生成素释放激素 A(LHRH A)对前列腺癌去势术后复发或转移患者的治疗效果。　方法　对 9例经活检病理确诊的前列腺癌去势术后复发转移患者应用LHRH A治疗 ,观察分析疗效。　结果　 9例中完全好转 (各项检查正常 ) 4例 ,其中维持 7年、3年、2年、1年各 1例 ;显著好转 (各项检查迅速明显好转或部分正常 ) 2例 ,稳定 (治疗 1个月PSA下降、前列腺硬结缩小 ,转移灶稳定 ) 3例。应用LHRH A者阴茎明显萎缩。　结论　LHRH A治疗对前列腺癌去势后复发或转移患者 ,大部分可获得明显效果 ,但随时间推移也可能产生耐药 ,疗效取决于前列腺癌细胞对药物的敏感性。