ABSTRACT
INTRODUCTION: The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characterized by hypokalemia, fluid retention, and hypertension. We experienced two cases of grade 4 hypokalemia associated with abiraterone treatment. CASE PRESENTATION: Case 1: a 71-year-old male with metastatic CRPC presented with convulsive seizures two weeks after receiving abiraterone plus prednisone. The serum potassium level was 2.1mEq/l. We determined that convulsive seizure was caused by hypokalemia associated with abiraterone. Case 2: a 68-year-old male with metastatic CRPC presented with severe lethargy one month after receiving abiraterone plus prednisone. The serum potassium level was 1.7mEq/l and we concluded that severe lethargy was caused by hypokalemia associated with abiraterone. They were treated with potassium supplementation and increased prednisone following withdrawal of abiraterone. DISCUSSION: The two patients had been on glucocorticoid therapy before abiraterone therapy. Prolonged administration of exogenous glucocorticoid can lead adrenocortical insufficiency and consequently reduce endogenous glucocorticoid production. This situation may increase the risk of abiraterone-induced mineralocorticoid excess. To reduce the risk of abiraterone-induced hypokalemia, evaluation of adrenocortical insufficiency is required.
ABSTRACT
We report a case of prostate cancer in a 41-year-old male. The patient initially visited another institution with a chief complaint of left breech pain. He was referred to our hospital for further investigation. Serum level of PSA was 267ng/ml and multiple bone metastases were found on bone scintigram. Digital rectal examination revealed a stony-hard prostate. Computed tomography showed multiple lung and lymph node metastases. Transperineal needle biopsy of the prostate revealed moderately differentiated adenocarcinoma (Gleason score 4ï¼5) frombilateral lobes (the 3th Edition). The patient was diagnosed with cT4N1M1c prostate cancer and maximal androgen blockade therapy was commenced.
Subject(s)
Adenocarcinoma/diagnosis , Prostatic Neoplasms/diagnosis , Adult , Humans , MaleABSTRACT
Case 1: A 50-year-old man was admitted to our hospital complaining of miction pain and fever up. Although there was remission by antibiotic treatment, symptoms recurred. Computed tomographic scan revealed swelling of scrotum and penis. Therefore, the patient was diagnosed with abscess of corpus cavernosum. The patient underwent debridement. Although symptoms remissed, he had erectile dysfunction. Case 2: A70-year-old man was admitted to our hospital complaining of perineal painful swelling. The patient was diagnosed with abscess of corpus cavernosum by computed tomographic scan. The patient underwent debridement, and symptoms remissed. If the patient is admitted to hospital complaining of miction pain and fever up, abscess of corpus cavernosum should be suspected.