RESUMO
BACKGROUND: The prognosis of prostate cancer (PC) is mainly determined by the presence or absence of metastases. An isolated testicular metastasis of PC is rare. CASE REPORT: A 71-year-old patient with PC presented with an increased serum prostate-specific antigen (PSA) level of 2.07 ng/ml two and a half years after radical prostatectomy. Assuming a local recurrence in the prostatic fossa, local radiotherapy with 64.8 Gy was performed. Unfortunately, the PSA level rose again, accompanied by a swelling of the left testis approximately one month after radiotherapy. A unilateral orchiectomy was then performed, presenting a testicular metastasis of the PC. After orchiectomy, the PSA decreased to <0.07 ng/ml. Two years later, the patient is still tumour-free. CONCLUSION: Careful clinical follow-up of patients with rising serum PSA level is important to recognize isolated, locally treatable metastastic disease. In particular, rare metastatic sites such as the testis or the epididymis should be taken into account before treatment of biochemical recurrence is initiated.
Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/secundário , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Idoso , Epididimo/patologia , Humanos , Imuno-Histoquímica/métodos , Masculino , Metástase Neoplásica , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Orquiectomia/métodos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/terapia , Recidiva , Neoplasias Testiculares/terapiaRESUMO
The detection of cellular antigens in bone marrow sections depends on the method of embedding, the nature of antigen and antibody, antigen retrieval techniques and the sensitivity of the immunohistochemical method. This study evaluated a fluorescyl-tyramide-enhanced immunostaining method on methyl-methacrylate-embedded bone marrow trephine biopsies. Compared with the standard immunostaining technique, fluorescyl-tyramide-enhanced immunostaining showed a superior signal intensity on methyl- methacrylate-embedded bone marrow trephines. Thus, the fluorescyl-tyramide-based immunostaining method, while retaining specificity, is highly sensitive and provides optimal staining results for a broad panel of antibodies commonly used for the routine diagnosis and classification of hematological disorders.
