Abstract
BackgroundAlthough there are reports linking ulcerative colitis (UC) to prostate cancer (PC), those reports are of PC patients who were previously diagnosed with UC. There are no reports of the development of UC during radiotherapy. Here we describe the first case of a patient who developed UC during radiotherapy for PC. The UC progressed rapidly and required emergency surgery.Case presentationA 61-year-old Japanese man underwent a prostate biopsy at another hospital due to a high prostate-specific antigen level and was diagnosed with PC. Goserelin and bicalutamide treatment was initiated in 2019, and intensity-modulated radiotherapy (total of 60 Gy/20 Fr) was administered in 2020. Diarrhea began during the radiotherapy and bleeding began post-radiotherapy. He was admitted to another hospital 14 days after the end of the radiotherapy, and colonoscopy revealed a deep ulcer in the colon, which led to the suspicion of UC. He was transferred to our hospital, and colonoscopy showed a widespread map-like ulcer, pseudopolyposis, and very easy bleeding in the colon. We diagnosed severe UC, and it worsened rapidly with uncontrollable bleeding, which we considered an indication for surgery. Emergency surgery (a total colectomy and ileostomy creation) was performed. The specimens confirmed an extensively spreading ulcer throughout the colon. The pathological report was UC in the active phase. The postoperative course was good.ConclusionsWhen a patient exhibits diarrhea while undergoing radiotherapy for PC, clinicians should be aware of the possibility of UC in addition to radiation colitis, and colonoscopy should be considered.
Highlights
There are reports linking ulcerative colitis (UC) to prostate cancer (PC), those reports are of PC patients who were previously diagnosed with UC
When a patient exhibits diarrhea while undergoing radiotherapy for PC, clinicians should be aware of the possibility of UC in addition to radiation colitis, and colonoscopy should be considered
The effect of radiation for PC on patients’ ulcerative colitis has been studied [4, 5, 7, 8], but those reports are of PC patients who were previously diagnosed with UC
Summary
Ulcerative colitis (UC) is a disease that begins with diarrhea and bleeding and gradually worsens, but it sometimes progresses rapidly to the point of requiring emergency surgery [1]. Case presentation A 61-year-old Japanese man had been treated for schizophrenia and showed a high level of prostate-specific antigen (PSA, 11.68 ng/mL) at a clinic He underwent a prostate biopsy at another hospital and was diagnosed with prostate cancer (Fig. 1). Three days post-admission, colonoscopy revealed a deep ulcer in the colon, which led to the suspicion of UC. The day, he was transferred to our Teikyo IBD Center (Fig. 2). The laboratory data were as follows: RBCs 356 × 104/μL (low), hemoglobin 9.9 g/dL (low), WBCs 9100/μL, platelets: 32.5 × 104/μL, total protein 4.7 g/dL (low), albumin 1.5 g/ dL (low), and CRP 14.41 mg/dL (high) He passed bloody diarrhea and the number of stools was > 10/day. The patient’s postoperative course was good, and he was discharged 26 days after the operation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
