前列腺癌伴单侧胫腓骨寡转移1例报告

A case report of unilateral tibia and fibula oligometastasis from prostate cancer

摘要

目的 探讨前列腺癌寡转移至单侧胫腓骨的诊断及治疗，为该类疾病的诊疗提供参考。病例报告 男性患者，85岁，因左下肢肿痛就诊。经计算机断层扫描（CT）、磁共振成像（MRI）、左胫骨活检病理及免疫组化、前列腺穿刺活检、全身骨显像等检查明确诊断：前列腺腺泡腺癌，Gleason评分9（4+5）分；全身骨显像提示左侧胫腓骨异常放射性浓聚灶，最终确诊为前列腺癌伴单侧胫腓骨寡转移。给予内分泌联合治疗后复查前列腺特异性抗原显著降低，前列腺MRI示原发病灶缩小。结论 前列腺癌可发生罕见的远端肢体寡转移，并作为首发表现，极易误诊为骨髓炎或其他骨病，对老年男性不明原因骨痛，应警惕此可能并及时筛查。

Abstract

Objective To investigate the diagnosis and treatment of oligometastatic prostate cancer with unilateral tibia and fibula involvement，so as to provide reference for the management of this condition. Case Report An 85-year-old male sought medical attention for left lower extremity swelling and pain.Diagnostic workup included computed tomography（CT），magnetic resonance imaging（MRI），pathological and immunohistochemical analysis of a left tibial biopsy，prostate biopsy，and a whole-body bone scan.These investigations confirmed prostate acinar adenocarcinoma with a Gleason score of 9（4+5）.The bone scan demonstrated foci of increased radiotracer uptake in the left tibia and fibula，establishing the final diagnosis of prostate cancer with unilateral oligometastasis to these bones.Following endocrine therapy，follow-up revealed a significant decrease in prostate-specific antigen（PSA）level along with shrinkage of the primary lesion on prostate MRI. Conclusion Prostate cancer can rarely manifest with distal limb oligometastases as its initial presentation，a condition prone to misdiagnosis as osteomyelitis or other bone disorders.This possibility should be considered and promptly screened in elderly males with unexplained bone pain.

关键词

转移性前列腺癌 / 胫腓骨 / 寡转移

Key words

metastatic prostate cancer / tibia and fibula / oligometastasis

参考文献

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