Non-Metastatic Prostate Cancer with Severe Anemia: Case Report and Literature Review

Abstract

Prostate cancer is one of the most common tumors of male urinary system and nearly causing any symptoms or signs in early stages. Complication as anemia has been rarely reported in non-metastatic prostate cancer. We present herein an extremely rare case of a local prostate cancer occurring in a 76-yearold man with a complication of severe anemia. As he was diagnosed of prostate cancer, he presented rising severe anemia with the hemoglobin level even down-regulated to 47 g/L. There has been no evidence of tumor metastasis to bone or bone marrow which mainly cause anemia in prostate cancer, supported by emission computed tomography and prostate specific membrane antigen positron emission tomography/computed tomography. According to his hematological tests, he was diagnosed with iron deficiency anemia. Despite the poor responsibility to erythropoietin and blood transfusion during the whole therapy period, his hemoglobin level gradually normalized 4 months after a robot-assisted radical prostatectomy with neoadjuvant endocrine therapy. To our knowledge, there was no such case of severe anemia accompanied with local prostate cancer ever described in the English literature. The case presentation is followed by a general discussion with an emphasis on the diagnosis and differential diagnosis. A review of literature regarding hepcidin and prostate cancer is also discussed.