RESUMEN
A 71-year-old man was first diagnosed with primary transitional cell carcinoma of the prostate with a skip lesion on the distal urethra. The patient received three courses of intra-arterial chemotherapy of cisplatin (CDDP) and pirarubicin (THP-ADM) followed by a radical prostatectomy. Histopathologic examination of the prostatectomy specimen revealed adenocarcinoma invasion along the prostatic duct extending to the peripheral acini, which was diagnosed as ductal adenocarcinoma. The clinical and histopathologic features of this case are entirely different from usual adenocarcinomas of the prostate. This rare histopathologic feature should be recognized as 'ductal carcinoma of the prostate', to distinguish it from papillary adenocarcinoma or adenocarcinoma with endometrioid features. The patient has had no sign of recurrence 14 months after the operation. CDDP-based chemotherapy followed by radical prostatectomy may be one of the promising therapeutic modalities for this rare entity.
Asunto(s)
Adenocarcinoma/patología , Carcinoma de Células Transicionales/patología , Neoplasias de la Próstata/patología , Adenocarcinoma/diagnóstico por imagen , Anciano , Carcinoma de Células Transicionales/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias de la Próstata/diagnóstico por imagen , UltrasonografíaRESUMEN
Effects of testosterone on the autonomic receptor-mediated function of the male rabbit urinary bladder and proximal urethra were examined. The alteration of alpha 1-, alpha 2-, beta-adrenergic receptor and muscarinic cholinergic receptor densities in the urinary bladder and proximal urethra were determined by radioligand binding techniques after castration. The density of alpha 1-adrenergic receptor in the proximal urethra decreased gradually after castration. This change was significant 8 weeks after castration. The alpha 2-adrenergic receptor density in the proximal urethra slightly increased after castration, but it was not statistically significant. The beta-adrenergic receptor density in the bladder dome did not change after castration. The density of muscarinic cholinergic receptor in the bladder dome significantly decreased in animals 2 weeks after castration. Additionally, the density of autonomic receptors and the response of muscle strips to autonomic drugs were compared in three age-matched experimental groups: control group, castrated group and castrated and testosterone supplemented group. When the autonomic receptor densities in the castrated group were compared to those of the control, the changes similar to the result in the previous experiment were noted. Testosterone supplementation restored the densities of alpha 1-adrenergic and muscarinic cholinergic receptors in castrated group to control levels. The responses of muscle strips to autonomic drugs closely paralleled the receptor densities. Castration decreased the alpha 1-adrenergic and the muscarinic cholinergic receptor function, however, testosterone restored those function. These findings indicate that testosterone affects the autonomic receptor-mediated function in the smooth muscle of lower urinary tract.