嚢胞状病変を形成した前立腺癌

Prostatic Cancer with Cystic Formation:A Case Report

　87歳，男性。主訴は無痛性肉眼的血尿。直腸診上，直腸前方に弾性軟，鵞卵大の腫瘤を触知した。CT,MRIにて，前立腺左葉に連続する径6cm大の壁不整な嚢胞状病変を認めた。血清PSAが高値であったため前立腺癌を疑い，嚢胞穿刺，前立腺針生検を施行した。病理組織診断は中分化型腺癌であり，嚢胞内容液のPSAは高値（PSA＞33,500ng／ml）であったため，嚢胞状病変を伴った前立腺癌と診断された。

A 87-year-old man presented with painless gross hema-turia. Huge elastic soft mass was palpable by digital rectal examination. CT and MRI studies demonstrated a retrovesi-cal cystic mass arisen from the left lobe of the prostate gland. As serum PSA was in high level, transrectal prostate needle biopsy and cyst puncture were performed. The cyst comprised bloody fluid with extremely high level of PSA (＞33,500 ng/ml) and biopsied specimen from the left prostate gland revealed moderately differentiated adeno-carcinoma. Clinically it was diagnosed as prostatic cancer with cyctic formation.