Noriharu Mikata

Breast Metastases of Prostatic Carcinoma: Immunohistochemical Case Study

A breast mass developed in a patient receiving estrogen therapy for prostatic cancer. The prostate tumor was adenocarcinoma of small acinar type, whereas that of the breast was infiltrating medullary adenocarcinoma. Histological features of the two tumors differed and double cancer was suspected by conventional pathological study. However, immunohistochemical staining with prostatic specific antigen and prostatic acid phosphatase was positive in each tumor. These results indicate the breast tumor to be a metastasis from the prostatic cancer.

CLINICAL STUDY ON PROSTATE-SPECIFIC ANTIGEN AND γ-SEMINO-PROTEIN LEVELS IN PATIENTS WITH PROSTATE CANCER

We measured blood levels of prostate-specific antigen (PSA) and γ-semino-protein (γSM) prior to therapy in 80 previously untreated patients with prostate cancer and calculated the PSA/γSM ratio (P/S). Forty-six patients with benign prostatic hyperplasia who had undergone subucapsular resection were served as controls. We measured the volume of the prostate gland by ultrasound before treatment, and the PSA (PSAD) and γSM (γSMD) levels per unit volume were calculated. The sensitivities of PSA and γSM were 0.9750 and 0.8125, respectively, thus being very high. On the other hand, the specificities were extremly low, being 0.1304 and 0.2391, respectively. Nevertheless, the PSA, γSM, P/S, PSAD and γSMD levels were all significantly higher in patients with prostatic cancer than in those with benign prostatic hyperplasia. Although it is difficult to differentiate between Stage A prostatic cancer and prostatic hyperplasia based on these markers alone, the high sensitivity of PSA for Stage A cancer (89%) suggests that biopsy should be performed at multiple sites when the PSA level exceeds the cutoff value.

CLINICAL STUDY OF THE BLADDER CARCINOMA

A clinical study of 102 patients with bladder cancer was made. The male to female ratio was 3.9:1, and the age rage was 29 to 89 years old (mean: 66). Hematuria was the chief complaint in 89 patients. Sixty-two cases were smokers. Twelve patients were complicated with another carcinoma. Ninety-eight cases had a transitional cell carcinoma. Eighty-seven cases were of G2 or C3 and 56 cases were of T1. Initial surgical procedure was TUR-BT in 78 patients, and total cystectomy in 19. The 3-year to 5-year survival rate was 77% and the mean survaival period was 1882 days. The lower the grade the higher were the survival rates. Superficial cancers showed a higher survival rate than that of invasive cancers.

A CASE OF BLADDER CANCER COMPLICATED WITH HYPERCALCEMIC CRISIS

A 76-year-old woman had bone metastasis after undergoing operation for a bladder cancer was urgently admitted to the hospital because of epigastric pain, general bone pain and unconsiousness on May 17, 1992. Abnormal high levels of blood calcium 14.2mg/dl and blood urea nitrogen 37mg/dl wee noted. The patient was diagnosied as hypercalcemic crisis. She was getting over the critical stage with administration of normal saline, frusemide and elcatonin. This paper presents the clinical course of this patient and some discussion on hypercalcemic crisis as oncologic emergency.