ABSTRACT
Antiandrogens are generally used for the treatment of prostate cancer, with gynecomastia the most common adverse event seen during therapy. However, a breast mass in a man with a carcinoma of the prostate may represent a metastatic disease or, less often, a primary carcinoma of the breast. Clinically diagnosed metastatic prostate cancer to the breast is a rare event. Breast metastasis represents an end-stage manifestation of the cancer, with an extremely poor prognosis. Herein, the case of a 62-year-old man, who presented with bilateral breast masses 7 months after antiandrogen therapy for the treatment of prostate cancer, is reported. An excisional biopsy of the breast mass revealed a metastatic prostatic adenocarcinoma.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma , Androgen Antagonists , Biopsy , Breast , Gynecomastia , Neoplasm Metastasis , Prognosis , Prostate , Prostatic NeoplasmsABSTRACT
PURPOSE: To evaluate the specific metabolic patterns of the prostatic tissue with prostatitis syndrome 1H-magnetic resonance spectroscopy was performed on the patients with prostatitis syndrome. MATERIALS AND METHODS: Between 1996 and 2001, 24 men aged 19-59 (mean 36.9) were evaluated for the impression of prostatitis syndome. Image and spectrum were obtained with GE Signa 1.5T MRI/MRS unit using a GP flexible surface coils. Scout images were obtained at axial plane with T2-weighted fast spin echo sequence, and 1H spectra were acquired in the localized single-voxel elements of the prostatic tissue with stimulated echo-acquisition mode sequence before and after therapy. RESULTS: Elevated levels of amino acids and decreased citrate were detected in the prostatic tissue with prostatitis syndrome in comparison with normal tissue. Spectral variations of amino acids metabolic signal were found between different patient groups, and recovery of spectral pattern after 1 month or 3 months of antimicrobials therapy was found. In chronic noninflammatory pelvic pain syndrome, amino acids levels were elevated as in other prostatitis, but patterns were different. CONCLUSIONS: 1H-magnetic resonance spectroscopy using external body surface coil can be a useful and non-invasive method to evaluate and to monitor therapeutic efficacy of prostate diseases including the prostatitis syndrome.
Subject(s)
Humans , Male , Amino Acids , Citric Acid , Pelvic Pain , Prostate , Prostatitis , Spectrum AnalysisABSTRACT
Complete urethral loss with vesicovaginal fistula is very infrequently encountered by the urologist. Urethral reconstruction may be accomplished with either bladder or vaginal wall flap. Moreover, it usually is necessary to reinforce the continence of reconstructed urethra with a well-vascularized pedicle flap from either the Martius labial flap, gracilis, perineum, or rectus. We report a case of the complete urethral loss with vesicovaginal fistula treated successfully with bilateral Martius labial fat graft.