臨床上肺転移のみを伴った前立腺癌

Isolated pulmonary metastases from prostate cancer

　症例は73歳，男性。2003年9月に検診でPSA 36.2ng/mlと高値を指摘され，当科を初診した。直腸診上，前立腺右葉外側に小豆大の硬結を触知した。前立腺生検前に行ったスクリーニング胸部X線検査上，両肺野にそれぞれ1か所，結節性腫瘤影を認めた。前立腺生検の病理診断は中分化型腺癌であり，全身検索の結果，他の部位に腫瘍を認めず，前立腺癌肺転移の診断で内分泌療法を開始し，肺病変は画像上CRを得た。

A 73-year-old man was referred to our clinic due to high PSA on medical checkup. His PSA level was 36.72ng/ml,and digital rectal examination revealed red-bean-sized,stony hard nodule in the right lobe of the prostate. The needles biopsy of the prostate revealed a moderately differentiated adenocarcinoma. A chest X-ray showed coin lesions in the bilateral lungs field. No other tumor was found,thus,the clinical diagnosis was pulmonary metastases from prostate cancer. Maximum androgen blockade therapy was performed and he achieved clinically complete response of the lung tumors.（Rinsho Hinyokika 60：485-487,2006）