ABSTRACT
PURPOSE: We attempted to identify the prostatitis in men with elevated serum prostate specific antigen (PSA) levels, and also determined whether treatment with antibiotics lowers serum PSA, resulting in decreases of the frequency of prostatic biopsies. MATERIALS AND METHODS: Men with lower urinary tract symptoms, and serum PSA greater than 4ng/ml, were evaluated for the presence of prostatitis. Prostatitis was defined as over 20 white blood cells in expressed prostatic secretions. Patients with prostatitis were treated with a 4-week course of antibiotics. Patient without signs of prostatitis underwent transrectal biopsies. PSA blood tests and prostatic massages were repeated 4 weeks later. Patients with PSA levels greater than 25ng/ml were excluded. RESULTS: Of the 49 patients with elevated PSA levels (with a mean PSA level of 9.26ng/ml), 29 (59%) had the laboratory signs of prostatitis. In 18 patients (62%) with prostatitis, the serum PSA level decreased to below 4ng/ml (mean 2.73ng/ml) after treatment. The remaining 11 patients with prostatitis, and the 20 patients without, underwent sextant transrectal ultrasound guided biopsies; which resulted in pathologic confirmation of prostate cancer in 3 out of the 11 patients with prostatitis, and in 4 (20%) out of the 20 patients without. Screening for prostatitis decreased the frequency of a prostatic biopsy by 32.7%. CONCLUSIONS: In over half of the patients with elevated serum PSA levels, the clinical evaluation revealed evidence of prostatitis. The treatment of prostatitis in this study decreased prostate biopsies by 32.7%. We suggest that screening for prostatitis in patients with elevated PSA levels, and it subsequent treatment can decrease the percentage of negative biopsies.
Subject(s)
Humans , Male , Anti-Bacterial Agents , Biopsy , Hematologic Tests , Leukocytes , Lower Urinary Tract Symptoms , Mass Screening , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms , Prostatitis , UltrasonographyABSTRACT
The teratoma is made up of a variety of parenchymal cell types representative of more than one germ layer. Retroperitoneal teratoma is an uncommon neoplasm which occurs in only 10% of all retroperitoneal primary neoplasm. Primary retroperitoneal teratoma has been rarely seen in adults and 3 cases has been reported in Korea. Recently we experienced a case of retroperitoneal teratoma, which was suspected by clinical investigation and confirmed by exploration and microscopic examination. CT scan is very useful in differential diagnosis of this rare tumor. We report a case of retroperitoneal teratoma in 22 year old young woman.