NDP102: Paratesticular dedifferentiated liposarcoma : a rare case report
例報告：軟組織寡轉移性前列腺癌
羅偉恩、黃家倫
振興醫療財團法人振興醫院泌尿部
Case Report: Soft Tissue Oligometastatic Prostate Cancer
Wei-En Luo, Chia-Lun Huang
Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan
Case presentation:
A 78-year-old male with history of prostate cancer status post bilateral lymph nodes dissection and unable to carry out radical retropubic prostatectomy due to severe intraabdominal adhesion in 2008. He received full course radiotherapy as further treatment. At urology outpatient department, regular follow-up of serum PSA level was stable below 10 ng/ml. However, rising PSA up to 12.4 ng/ml was noticed in 2024. Whole abdominal computed tomography scan revealed 2.6 cm enhancing soft tissue mass located at left anterior to the urinary bladder. Whole body bone scan showed no evidence of bony metastasis.
The patient received surgical excision of the intra-abdominal tumor and the pathology report showed a picture of adenocarcinoma, composed of pleomorphic and hyperchromatic tumor cells arranged in glandular, fused glandular, cord or isolate single cell patterns. Based on the histopathologic and immunophenotypic findings, the tumor is compatible with prostatic adenocarcinoma. He recovered well after surgery and was scheduled to re-check serum PSA level one month after surgery.
Discussion:
Treatment for oligometastatic prostate cancer, where the cancer has spread to a limited number of other sites (typically fewer than 5), aims to control and potentially eradicate metastases to improve survival and quality of life. Approaches may vary depending on patient factors, cancer characteristics, and the specific metastatic sites, but common treatment strategies include androgen deprivation therapy, radiotherapy, surgery (metastasectomy). Surgically remove metastatic sites, typically lymph nodes or isolated bone metastases may be an option in carefully selected cases and can be curative when combined with other therapies. Although metastatic prostate cancer presents most commonly in bone, lymph nodes, lungs, and liver, metastatic disease presenting as a soft tissue mass is extremely rare. Surgical excision followed by adjuvant radiotherapy or androgen deprivation therapy may be feasible treatment for these patients.