前立腺癌と膀胱小細胞癌の重複癌の1例

Double primary cancers composed of adenocarcinoma of the prostate and small cell carcinoma of the urinary bladder：A case report

　症例は75歳，男性。1999年11月に腰痛を主訴に当院を初診した。多発性骨転移と縦隔リンパ節転移を伴う前立腺癌を認め，内分泌療法を開始した。血清PSAは0.3ng/ml未満に低下したが，2001年11月全身倦怠のため当科に入院した。入院後全身状態が急速に悪化し，原疾患が明らかでないまま，2002年2月死亡した。剖検上，前立腺癌，および肝，リンパ節，骨などに転移を伴う膀胱小細胞癌と考えられた。

　A 75-year-old man with a chief compliant of lumbago was admitted to our hospital in November,1999. He had increased serum PSA level（945.6ng/ml）and biopsy of the prostate revealed poorly＞moderately differentiated adenocarcinoma. Various examinations showed metastases to systemic bones and mediastinal lymph nodes. Hormonal therapy was started and serum PSA level decreased to＜0.3ng/ml. However,he developed general malaise in November,2001,and died in February,2002. Autopsy revealed adenocarcinoma of the prostate and small cell carcinoma of the urinary bladder with multiple metastases in liver,gall bladder,pancreas,spleen,right kidney,thyroid gland,parathyroid grands,lymph nodes and bones.