案例報告 – 以攝護腺尿道憩室表現的攝護腺癌

鄧子麒、邵翊紘

林口長庚醫院 外科部 泌尿科

Case report – a prostate adenocarcinoma presenting with diverticulum over prostate urethra.

Tzu-Chi Teng, I-Hung Shao

Division of Urology, Department of Surgery, Chang Gung Memorial Hospital

Abstract: A 58-year-old gentleman was initially presented with mild lower urinary tract symptoms under medication. Transurethral ultrasound of the prostate showed 43ml and uroflowmetry showed peak flow rate: 10 ml/s, average flow rate: 5 ml/s and residual urine: 0 ml. However, elevated PSA from 4.86 to 8.82 ng/ml was noted during follow up. For the risk of prostate cancer, multiparametric magnetic resonance imaging scan was arranged and showed 2.6 cm diverticulum over prostate urethra and right T zone PIRAD 3 lesion. Bone scan showed no definite bony metastases. Cystoscope showed a diverticulum over right lateral of prostate urethra near verumontanum. Guild wire inserted smoothly, and the whitish content was release from the diverticulum. Transperineal MRI fusion biopsy was done and showed adenocarcinoma, Gleason score 3 + 3 = 6 (Grade Group 1). Under the impression of prostate adenocarcinoma, cT2aN0M0, low risk, the patient received robot-assisted laparoscopic radical prostatectomy for definite treatment. Continence immediately after foley removal and no erection dysfunction was told. Pathology report showed acinar adenocarcinoma, Gleason score 3 + 4 = 7 (Grade Group 2), pT2Nx, margin negative. Regular follow up for PSA was arranged.