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Case Presentation

Case Presentation . HKC 1392. A 65 y/o man Decrease urinary force and caliber since 6 month ago. LUTS (+) Fatigue(+) Weight loss(+). Past medical history Negative . Physical examination Abdomino pelvic Exam: Normal Genitourinary Exam: Normal

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Case Presentation

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Presentation Transcript

  1. Case Presentation • HKC 1392

  2. A 65 y/o man • Decrease urinary force and caliber since 6 month ago. • LUTS(+) • Fatigue(+) • Weight loss(+)

  3. Past medical history • Negative

  4. Physical examination • Abdomino pelvic Exam: Normal • Genitourinary Exam: Normal • DRE:+ 1/Firm/symmetric/without nodule

  5. Lab Data • LDH: 1044 • AlKp: 1826 • Cr: 1.2 • PSA: > 100

  6. TRUS GUIDED BIOPSY Prostate:1391/6/21 Adenocarcinoma of prostate Rt base : Empty specimen Rt upper- mid : 4+5 (50%) Rt lower- mid : 4+5 (80% ) Rt apex : 4+5 ( 70%) Other specimens: benign prostatic tissue PNI (+) Extra prostate (-)

  7. Whole Bone Scan Multiple Bone Metastasis

  8. Hormone therapy • Diphereline (monthly) • Flutamide ( 1 month) • Zometa (4 mg SC monthly)

  9. Total Androgen Block (TAB) • Flutamide+ Diphereline

  10. Anti Androgen Withdrawal • Flutamide D.C • Testosterone (92.2) : 0.1

  11. Chemotherapy • Estramustine

  12. What is the next Plan?

  13. Thanks for Attention

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