Case Of Carcinoma Prostate Research Articles

Metastasis to spermatic cord from carcinoma prostate: A case series

Despite the high incidence of secondaries to lymph nodes, bones, and lungs in carcinoma (CA) prostate, metastatic involvement of scrotal organs is rare and usually associated with a poor prognosis. Here, we report a case series of three cases of CA prostate with metastatic involvement of scrotal organs. All three patients had metastatic involvement of the spermatic cord, with involvement of epididymis in the first patient and testes in the third patient, revealed incidentally on orchiectomy. Two patients were also found to have coexisting lymphatic filariasis. To date as per the best of our knowledge, only one such case of CA prostate with metastasis to scrotal organs and associated filariasis has been reported. This highlights the need for histopathological evaluation of all orchiectomy specimens. Chronic infection and inflammation leading to lymphatic obstruction due to filariasis probably led to the unusual retrograde spread of the tumor.

Metastatic Thyroid Cartilage Lesion from Prostatic Adenocarcinoma on 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography-Computed Tomography Scan

Prostate cancer usually metastasizes to regional lymph nodes and bone. Laryngeal cartilage metastases are very rare and only few cases have been published so far describing thyroid cartilage metastatic lesions from prostate cancer. Here, we describe 5 cases of carcinoma prostate, 3 staging and 2 follow-up, where 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PET/CT) scan revealed multiple skeletal lesions along with thyroid cartilage metastasis. Initially, laryngeal cartilage metastases remain asymptomatic and in later stages patients present with symptoms. These metastatic lesions to thyroid cartilage are rare entities and can often easily be missed on conventional imaging. PET-CT imaging has overcome this diagnostic problem due to its ability to provide for both anatomical and functional imaging.

Voxel based evaluation of sequential radiotherapy treatment plans with different dose fractionation schemes.

This study presents a methodology for voxel-based evaluation of two phase sequential radiotherapy treatment plans having conventional dose scheme in the first phase and subsequent hypofractionation dose scheme in the second phase based upon different priority [planning target volume (PTV), clinical target volume (CTV) and organs at risk (OAR)] of display modes. A case of carcinoma prostate was selected for demonstration. Varian Eclipse treatment planning system (TPS) was used for contouring and planning. In the first phase, a dose of 52 Gy in 26 fractions to the PTV and in the second phase, a dose of 19.5 Gy in 3 fractions to the PTV Boost was planned on the same CT data set. Both the plans (Phase 1 and Phase 2) were exported and processed using "Voxel-based radiobiology display (VRb) tool". Plan Sum for Biologically effective dose (BED)-Cube and equivalent dose of 2Gy (EQD2)-Cube was reconstructed using a combination of linear quadratic (LQ) and linear quadratic-linear (LQ-L) radiobiological models. Tumor control probability (TCP) and normal tissue complication probability (NTCP) for different target volumes and organs were also calculated using EQD2-volume histograms of the Plan Sum. An in-house graphical user interface (GUI) is developed to present the qualitative and quantitative evaluation of the multiphase treatment plans with different display modes and dose regimens. The voxel based TCP obtained for the combined target volume was 90.56%. NTCP for the bladder and rectum was calculated from the Plan Sum histograms and found to be 0.33% and ~0.0% respectively. The proposed methodology using the VRb tool offers superior plan evaluation for multiphase sequential radiotherapy treatment plans over the existing methods. PTV, CTV and OAR priority based display modes in VRb tool offers better understanding of radiobiological evaluation of sequential radiotherapy treatment plans.

Frequency of Carcinoma Prostate in Patients presenting with Clinically Benign Enlarged Prostate

Background: Benign Prostatic hyperplasia is one of the commonest physiological ageing process of males. Among these, there arechances of conversion of this benign condition into malignancy. Initially benign prostatic hyperplasia was tried to be controlled withmedication. Then came the era of open surgery in the form of Trans-vesical prostatectomy and now-a-days minimally invasive techniqueof trans-urethral prostatectomy is on the surge. With the passage of time, there is increasing trend in performing histo-pathology of anytissue taken out from the body and this has resulted in very fruitful results.Objective: To determine the frequency of carcinoma prostate in those patients who were clinically suspected as having bening enlargedprostate.Material and Methods: This study was conducted in Surgical units and Urology unit of Saidu Group of Teaching Hospitals, Swat from2013 to 2015. A total of 200 patients were included in the study. An exclusion criteria was made so as to exclude confirm cases ofcarcinoma prostate from the study. After performing trans-vesical and trans-urethral prostatectomy, the specimens were sent for histopathology.Results: 200 patients were selected for the study who were clinically assigned as having benign prostatic hyperplasia according to ourinclusion criteria. Out of these 200 subjects, 32 (16%) came out to be having carcinoma prostate while 168 (84%) patients retained theoriginal clinical diagnosis upon histo-pathology.Conclusion: Rather than assigning a patient as having benign enlarged prostate on clinical grounds, it is better to perform histopathologybecause there is a vast difference of management plan of a benign condition as compared to a malignant condition.

Spinal Tuberculosis Mimicking as Prostate Cancer Metastases in Ga-68 Prostate-specific Membrane Antigen Positron-emission Tomography/Computed Tomography.

Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein which is overexpressed in prostate cancer. However, the widespread use of PSMA positron-emission tomography (PET) scan revealed various nonprostatic PSMA-avid diseases. Here we present a report of a known case of carcinoma prostate, post orchidectomy, radiotherapy, on hormonal therapy with complain of back pain, referred for Ga68 PSMA PET/CT scan. The scan revealed PSMA-avid lesion of contiguous D6 and D7 vertebrae with associated soft-tissue component. The biopsy of the lesion was suggestive of tuberculosis.

Surgical Management and Post-Operative Outcomes of Urinary Outflow Obstruction: Experience of 50 Cases in Bangladesh

Background: Management of urinary outflow obstruction is very crucial.Objective: The purpose of the present study was to see the different management of urinary outflow obstruction with their post-operative outcomes.Methodology: This non-randomized clinical trial was conducted in the Department of Surgery at Rajshahi Medical College, Rajshahi, Bangladesh from September 1994 to December 1995 for a period of one year and three months. All the patients who were presented with bladder outflow obstruction and were admitted in the general surgical unit of the hospital were taken as study population. These patients were surgically managed in different procedures. The follow up was done to record the post-operative surgical outcomes.Result: A total number of 50 patients were recruited for this study. Benign enlargement of prostate was found in 13 cases of which 11(22.0%) cases were managed by suprapubic transvesical prostatectomy. Impacted urethral stone was found in 13 cases of which 4(8.0%) cases were managed by urethro-lithotomy followed by repair of urethra and indwelling catheter. Stricture urethra was found in 11 cases and all cases (100.0%) cases were managed by intermittent dilatation under general anesthesia. In 7 cases of rupture urethra, initially all patients were managed by suprabpublic cystostomy which was 7(14.0%) cases in number. All the 3 cases of carcinoma prostate were managed by prostatectomy and radiotherapy plus hormone therapy. A total number of 16 patients were managed by prostatectomy of which 1(2.0%) case was developed immediate postoperative hemorrhage which was managed by blood transfusion and continuous irrigation with normal saline. One patient developed postoperative clot retention due to blockage of Foley’s catheter, two patients developed postoperative incontinence, immediately after removal of the catheter. Out of 11 patients of impacted urethral stone, one developed urethral fistula and one developed UTI. Recurrent stricture urethra occurred in 3 patients. Seven patients with rupture urethra, 3 developed stricture urethra and 3 developed stricture urethra.Conclusion: In conclusion different surgical procedure are employed during the management of urinary outflow obstruction and immediate postoperative hemorrhage, postoperative clot retention, postoperative incontinence, urethral fistula, UTI and recurrent stricture urethra are the most common complication after surgical management of urinary outflow obstruction patients.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 84-88

The changing scenario in diagnosing prostate cancer

Fifty patients were evaluated for serum total PSA (Prostate Specific Antigen), free PSA (f-PSA), free/total PSA ratio (f/t PSA ratio) and TPS(TM) (Tissue Polypeptide Specific Antigen). Fifty patients were clinically evaluated and categorized into BPH (benign prostatic hypertrophy) and CaP (carcinoma prostate) with twenty-five in each category before the serological examination. Serum total PSA concentration is elevated in 80% of BPH cases while it was elevated in all cases of CaP. With total PSA>10ng/mL, f/t PSA ratio was not applicable. For TPS(TM), a cell proliferation marker these values were 32% and 92% respectively. The advanced cases of CaP were reflected by the pronounced elevations of PSA and TPS(tM) while f/t PSA ratio was much below the cut-off limit (cut-off limit=0.14). The data suggest that whentotal PSA concentration <10ng/mL, f/t PSA ratio plays a very important role in discriminating BPH and CaP. However, TPS(TM) can be used as a valuable adjunct in diagnosis and follow-up of prostate cancer patients, especially in differentiating benign from malignant cases.