Long-acting testosterone injections for treatment of testosterone deficiency after brachytherapy for prostate cancer.

OBJECTIVE: To evaluate the clinical and biochemical effects of long-acting testosterone undecanoate injections in men with prostate cancer treated with brachytherapy, as the use of testosterone therapy (TTh) in men with prostate cancer is highly controversial, with limited published safety data, particularly after brachytherapy treatment. PATIENTS AND METHODS: In all, 20 men treated with brachytherapy for prostate cancer received TTh for symptoms of testosterone deficiency from February 2005 to August 2013. Symptoms of testosterone deficiency included low libido, erectile dysfunction, and fatigue. The mode of TTh was long-acting testosterone undecanoate injections in all cases. Sexual function was assessed by Sexual Health Inventory for Men (SHIM) questionnaire. Serum PSA and testosterone concentrations were recorded monthly for 3 months, then every 3 months for the first year, every 6 months for the second year, and annually then after. RESULTS: The mean (range) age was 62 (49-74) years and the mean (range) serum PSA level at the time of prostate cancer diagnosis was 6.2 (2-11.5) ng/mL. The Gleason score was 2 + 3 in one patient, 3 + 3 in 15 patients, 3 + 4 in three patients and 4 + 4 in one patient. In all, 15 men were stage T1c and five were T2a. The mean (range) baseline total testosterone concentration was 343 (200-592) ng/dL, and 6.9 (2.1-9.7) ng/dL for free testosterone. The mean SHIM scores improved with treatment from 16.1 at baseline to 22.1 with TTh (P = 0.002). There was a decrease in mean PSA level from baseline of 0.7 ng/mL before initiation of TTh to 0.1 ng/mL at last follow-up (P < 0.001), with a median (range) follow-up of 31 (12-48) months. There were no cases of prostate cancer progression or recurrence. CONCLUSIONS: With a median of 31-months follow-up, long-acting testosterone injections in men with prostate cancer treated with brachytherapy produced significant clinical benefits. There were no cases of rising serum PSA, prostate cancer progression or recurrence.

Metástasis inguinal por cáncer testicular: a propósito de un caso / Inguinal metastasis secondary to testicular cancer

La metástasis inguinal ganglionar por cáncer testicular es rara, sobre todo en pacientes con tumor tipo seminoma y sin antecedentes de cirugía en la región inguinal o escroto. Presentamos un caso de un paciente de 48 años con diagnóstico de seminoma testicular izquierdo etapa IIa, tratado con 4ciclos de quimioterapia, que desarrollo una recidiva inguinal 4 meses después del tratamiento primario, sin evidencia de enfermedad retroperitoneal a distancia. Realizamos una revisión de la literature respecto del tema.

The inguinal metastasis from testicular cancer is rare, especially in patients with no history of previous surgery in the inguinal zone. We present a case of 28 years old man, with seminoma testicular cancer, stage II, in whom secondary to the 4th chemotherapy cycle, evolve with an inguinal metastasis, four months after the primary treatment, without evidence of disease in other localitation.

Sarcoma vesical primario durante el embarazo, el primer caso publicado / Primary bladder sarcoma in pregnancy: the first case report

Los sarcomas vesicales primarios son tumores extremadamente raros, constituyendo menos del 1 por ciento de todos los tumores primarios de vejiga, con casos reportados esporádicamente. El embarazo trae consigo un problema complejo a cualquier patología urológica, especialmente oncológicas. Presentamos el primer caso publicado de sarcoma de vejiga en una mujer embarazada chilena de 28 años de edad, que dio a luz un recién nacido sano, además de una revisión de la literatura al respecto.

Primary bladder sarcomas are extremely rare tumors, representing less than 1 percent of the primary tumorsof bladder, being reported sporadically. Urologic problems become more complex to treat during pregnancy, especially oncologics diseases. We present the first known case of bladder sarcoma diagnosed in a pregnant 28 years old Chilean. Areview of literature was performed.