Case 5-2011 — A 65-Year-Old Man with Hematuria after Treatment for Prostate Cancer  

Oleh:

Kaufman, Donald S. ; Zietman, Anthony L. ; Dahl, Douglas M. ; Harisinghani, Mukesh G.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 07 (Feb. 2011), page 667-675.
Topik: Genitourinary Oncology Clinic; Hematuria

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Presentation of Case Dr. Donald S. Kaufman: A 65-year-old man was seen in the multidisciplinary genitourinary oncology clinic of this hospital because of the recent onset of hematuria. The patient had been well until 10 years earlier, when a core needle biopsy was performed at another facility because of a serum prostate-specific antigen (PSA) level of 7.6 ng per milliliter (reference range, 0 to 4); a diagnosis of adenocarcinoma of the prostate was made (Gleason score, 6 [grade 3 plus grade 3], involving less than 5% of one of six cores of tissue examined; the Gleason score is the sum of the two most common histologic grades in a prostate tumor, each of which is rated on a scale of 1 to 5, with 5 being the most cytologically aggressive). The prostate was normal on physical examination, and the clinical stage was T1cN0M0. Brachytherapy was administered, with permanent implantation of 112 radioactive (iodine-125) seeds. Computed tomography (CT) of the abdomen and pelvis, performed after implantation, was thought to show even distribution of the seeds throughout the prostate. The brachytherapy was complicated by urinary retention and uremia, which required temporary hemodialysis and the placement of a suprapubic tube; the complications resolved, and the patient had full continence. Twenty-two months after the implantation procedure, the level of PSA was 0.6 ng per milliliter; the level was <0.1 ng per milliliter 5 years after the procedure.

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