[Prostate carcinoma with squamous differentiation after combination endocrine therapy: a case report].

We report a case of squamous differentiated prostate carcinoma that developed after combination endocrine therapy for adenocarcinoma of the prostate. The patient was a 68-year-old man who visited our hospital with microscopic hematuria. His serum prostate-specific antigen (PSA) level was 7. 06 ng/ml. Transperineal needle biopsy was performed and histological examinations indicated moderately differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8. Computed tomography showed swelling of left external iliac lymph node. The clinical stage was T3aN1M0. Six weeks after combination endocrine therapy using goserelin acetate and bicalutamide, the patient underwent radical prostatectomy and bilateral pelvic lymphadenectomy. Histopathological examination of the surgical specimen demonstrated squamous cell carcinoma of the prostate with very small areas of adenocarcinoma. The treatment measure was changed from endocrine therapy to combination chemotherapy consisting of docetaxel, cisplatin, and 5- FU. Eighteen month has passed after the surgery without any evidence of distant metastasis.

[A case report of idiopathic hypogonadotropic hypogonadism with particular reference to monitoring of prostate volume].

A 23-year-old man visited our hospital, complaining of a lack of secondary sexual characteristics. Based on both clinical and endocrinological examinations, he was diagnosed as suffering from idiopathic hypogonadotropic hypogonadism (IHH). With human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) replacement therapy, clinical symptoms and serum testosterone levels improved to normal ranges. Interestingly, prostate volume as measured by transrectal ultrasonography increased considerably from 3.6 ml before treatment to 20.2 ml after treatment. The monitoring of prostate volume might be a parameter useful for evaluating the treatment effect of hCG/hMG replacement therapy in IHH.

[Primary symptoms of 301 patients with prostate cancer: Nagoya Urology Hospital experience].

PURPOSE: Primary symptoms were reviewed retrospectively in patients with prostate cancer diagnosed in our hospital with the aim of promoting early detection. MATERIALS AND METHODS: The subjects included 301 cases with prostate cancer diagnosed histologically in Nagoya Urology Hospital from August, 1988 to December, 2001. The mean age was 72.7 years, and the median PSA was 20.0 ng/ml. Primary symptoms were classified according to the General Rule for Clinical and Pathological Studies on Prostate Cancer (The 3rd Edition). RESULTS: Out of 301 cases, 274 (91%) visited our hospital with clinical symptoms. Of them, 272 had primary urological symptoms. In these 272 cases, 250 (92%) and 19 (7%) had lower urinary tract symptoms (LUTS) and macroscopic or microscopic hematuria, respectively. The majority of patients (82%) referred from other urologists had already undergone PSA measurement, compared to 50% in those referred from physicians other than urologists (p < 0.0005). CONCLUSION: The present data revealed that LUTS were important primary symptoms for the detection of prostate cancer, particularly in an area like Nagoya where the mass screening for prostate cancer is still unavailable. In terms of the early detection of prostate cancer, PSA has to be measured in patients with LUTS even when they visit physicians who are not urologists.