A giant primary sclerosing lipogranuloma of the scrotum.

Sclerosing lipogranuloma is a rare, benign disease that can affect several organs, particularly of genitourinary system in males. The majority of the cases are secondary to exogenous foreign bodies. The masses are composed of granulomatous tissue formed around an either exogenous or endogenous lipomatous substance. We describe a 47-year-old male patient who presented with a growing, painless scrotal mass on physical examination. The mass was in 20 cm diameter and the laboratory findings were in normal limits. Pathologic evaluation confirmed the diagnosis of scrotal sclerosing lipogranuloma. To the best of our knowledge, this is the biggest scrotal sclerosing lipogranuloma case in the literature. We aimed with this presentation to keep in mind this benign lesion and also to assist the algorithmic approach.

The prognostic importance of prostate specific antigen in the monitorisation of patients undergoing maximum androgen blockade for metastatic prostate cancer.

INTRODUCTION: The changes in serum prostate specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockade for metastatic prostate cancer. MATERIAL AND METHOD: A total of 149 patients followed up in our department were classified into 4 groups on the basis of PSA changes: group 1; those with normalisation of PSA levels within the first 3 months, group 2; those with normalisation PSA between months 3 and 6, group 3; those with a decrease in PSA but not reaching normal range, group 4; those with no decrease. The gleason scores and the number of bone metastases were also compared between the groups. RESULT: The time to progression was significantly delayed in group 1 (mean: 23.3 months) compared to those with group 2 (mean: 16.9 months) (P<0.02). The time to progression in group 3 (mean: 8.45 months) was significantly shorter compared to the first two groups (P<0.001). Also, in patients with gleason scores 5-7 (grades 2) and gleason scores over 7 (grade 3) and group 1, the time to progression (mean: 21.2 months) was significantly delayed compared to those with the same gleason scores but with group 2 (mean: 13.4 months) (P<0.001). CONCLUSION: The decrease in PSA level is more important than gleason scores in determining the time to progression. Early normalisation of PSA delays the time to progression, and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.

The prognostic importance of prostate-specific antigen in monitoring patients undergoing maximum androgen blockage for metastatic prostate cancer.

The changes in serum prostate-specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockage for metastatic prostate cancer. A total of 149 patients followed in our department were classified into 4 groups on the basis of PSA changes: group 1, those with normalisation of PSA levels within the first 3 months; group 2, those with normalisation of PSA between months 3 and 6; group 3, those with a decrease in PSA, but not reaching normal range; group 4, those with no decrease. The gleason scores and the number of bone metastases were also compared between the groups. Again time to progression in patients with Gleason scores 5-7 (grade 2) and over 7 (grade 3) whose PSA levels decreased between first and 3rd months (mean 21.2 months) were significantly longer than the patients with same gleason scores whose PSA levels decreased between 3rd and 6th months (mean 13.4 months) (p< 0.001). The decrease in PSA level is more important than gleason scores in determining the time to progression. Early normalisation of PSA delays the time to progression and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.