前列腺癌腹膜后转移合并下腔静脉瘤栓1例并文献复习

Retroperitoneal metastasis of prostate cancer with inferior vena cava thrombola:case report and literature review

目的探讨前列腺癌(PCa)腹膜后转移合并下腔静脉瘤栓临床表现及诊治,并行文献复习。方法报道1例PCa腹膜后转移合并下腔静脉瘤栓患者,表现为下腹部钝痛,伴下腹部、阴茎、阴囊、双下肢水肿,CTU及MRI提示腹膜后肿瘤,下腔静脉瘤栓,PCa。以PCa收治,超声引导下腹膜后穿刺提示:PCa腹膜后转移。结果根据病理学特点及免疫组化诊断为PCa腹膜后转移,给予亮丙瑞林联合恩扎卢胺药物治疗,目前患者下腹部及下肢水肿完全消失,下腔静脉再通。结论PCa转移最常见于骨和淋巴结,腹膜后转移合并下腔静脉瘤栓临床罕见,在老年患者PSA异常时应考虑到PCa转移的可能,ADT联合恩扎卢胺治疗效果良好。

Objective To investigate the clinical manifestations,diagnosis and treatment of retroperitoneal metastasis of prostate cancer(PCa)complicated with inferior vena cava tumor thrombolus.Methods A case of retroperitoneal metastasis of PCa with inferior vena cava tumor thrombus was reported.The patient presented with dull pain in the lower abdomen accompanied by edema in the lower abdomen,penis,scrotum and lower limbs.CTU and MRI suggested retroperitoneal tumor,inferior vena cava tumor thrombus and PCa.The patient was admitted with PCa and ultrasound guided retroperitoneal puncture suggested retroperitoneal metastasis of PCa.Results According to pathological features and immunohistochemistry,the patient was diagnosed as retroperitoneal metastasis of PCa.He was administrated with lepraline combined with endzalumide,and at present,the edema of lower abdomen and lower limbs was completely cured,and the inferior vena cava was recanalized.Conclusion Bone and lymph nodes are the most common metastasis site of PCa.Retroperitoneal metastasis combined with inferior vena cava tumor thrombus is rare in clinic.The possibility of PCa metastasis should be considered when PSA is abnormal in elderly patients.ADT combined with enzalumide has a good therapeutic effect.