Abstract
A 70-year-old Type 2 diabetic male patient was referred with a rapidly growing lump in the right breast. He had been on Bicalutamide (Casodex®, AstraZeneca) 150mg monotherapy for about 12 months for Gleason 8 (3 + 5) adenocarcinoma of the prostate gland and had developed breast tenderness and gynaecomastia 3 months after commencing treatment. Pre-treatment bone scan and serum alkaline phosphatase levels were normal. Though he had undergone a radical left nephrectomy 9 years earlier for renal cell carcinoma, his family history did not suggest a genetic predisposition to malignancies. He responded favorably to Bicalutamide as reflected in his serum prostatic specific antigen (PSA) levels, which dropped from 211 to 1.4ng/ml after 6 months of treatment and remained normal after 18 months.
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