RESUMO
BACKGROUND: The purpose of this study was to determine the incidence and mortality rate of prostate cancer in men without a rectum at a single institution. The usefulness of serum prostate specific antigen (PSA) to screen for prostate cancer in men without a rectum was defined. Improved biopsy techniques and therapeutic options were developed in those with elevated levels. METHODS: We undertook a retrospective review of 65 men who underwent an abdominoperineal resection. Twenty-five of these men underwent serum PSA determinations (mean age, 68 years). RESULTS: Four (16%) of 25 patients had elevated PSA levels. Three of these four men and two additional patients (one before the availability of PSA and one with normal serum PSA level) were found to have biopsy-proven prostate cancer. Two men (3% of the 65 patient population) died of metastatic prostate cancer. CONCLUSIONS: We believe that men about to undergo an abdominoperineal resection should have a preoperative serum PSA measurement. Moreover, we recommend that men older than 49 years of age (older than 39 years for those with positive family histories) without a rectum should have annual serum PSA determinations as if recommended for the general male population at large. If an elevated serum PSA level is discovered, the transperineal ultrasonogram-guided biopsy technique offers an effective method to detect peripheral zone prostate cancers.
Assuntos
Adenocarcinoma/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Antígeno Prostático Específico/sangue , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Reto/cirurgia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Humanos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/diagnóstico por imagem , Segunda Neoplasia Primária/cirurgia , Projetos Piloto , Próstata/diagnóstico por imagem , Prostatectomia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , UltrassonografiaRESUMO
We have observed hyperplastic epidermal lesions in sun-damaged skin on the backs of the hands, wrists, and forearms that, in some examples, contain foci of invasive squamous cell carcinoma. Atypia in these lesions is focal or absent. Because of their bland histology, physicians are likely to interpret small or superficial biopsies as indicating a benign lesion. However, careful clinical correlation and follow-up are recommended, as residual tissue may contain invasive carcinoma or its precursor.
Assuntos
Carcinoma de Células Escamosas/complicações , Dermatoses da Mão/complicações , Ceratose/complicações , Neoplasias Cutâneas/complicações , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Epitélio/patologia , Feminino , Dermatoses da Mão/patologia , Humanos , Hiperplasia , Ceratose/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Cutâneas/patologiaRESUMO
The Kidney Stone Center in Fort Lauderdale, Florida, is an ambulatory ESWL facility where 226 patients have been treated since July, 1985. A total of 258 kidneys were treated over a period of five months with a success rate of 99 per cent. The post-treatment admission rate, both immediate and delayed, was 14.2 per cent. Outpatient ESWL treatment of both renal and ureteral calculi is feasible, medically safe, and cost-effective.
