高度血尿で発症した若年性前立腺癌

Prostate Cancer in a 43-year-old Man with Severe Gross Hematuria:Report of a Case

　43歳，男性。主訴は高度血尿。出血性ショックの状態で近医にて緊急開腹止血術施行後，当科へ転院となる。手術時の病理組織は低分化型腺癌で，転院時の血清PSA値は1,400ng／mlであった。前立腺癌stage D2と診断し，抗男性ホルモン療法を開始した。4週後にはPSA値も22ng／mlにまで低下し，症状も軽快し退院した。45歳以下の前立腺癌症例は比較的稀で，本邦で18例を数えるに過ぎず，高度血尿を主訴とする例は自験例が初めてである。

A 43-year-old man was referred and hospitalized to our hospital after hemostatic operation performed at other hospital because of severe gross hematuria and shock. The specimen resected at the operation was diagnosed as poorly differentiated adenocarcinoma histopathologically. Serum PSA level was 1,400 ng/ml and CT revealed pelvic lymph-node involvement and bone metastasis. He was treated with diethylstilbestrol diphosphate and 4weeks later serum PSA level decreased down to 22ng/ml. He was the 18th patient of prostate cancer younger than 45-year-old in Japan. The prognosis of prostate cancer in young adult is very poor.