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Cancer of Unknown Primary Finally Revealed to Be a Metastatic Prostate Cancer: A Case Report

Title
Cancer of Unknown Primary Finally Revealed to Be a Metastatic Prostate Cancer: A Case Report
Authors
Cho, Jung YeonShim, Eun JinKim, In SeonNam, Eun MiChoi, Moon YoungLee, Kyung EunMun, Yeung ChulSeoung, Chu MyoungLee, Soon NamSong, Dong EunHan, Woon Sup
Ewha Authors
이순남성주명이경은송동은
SCOPUS Author ID
이순남scopus; 성주명scopus; 이경은scopus
Issue Date
2009
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
1598-2998JCR Link
Citation
vol. 41, no. 1, pp. 45 - 49
Keywords
P504SMetastatic prostate cancerCancer of unknown primary
Publisher
KOREAN CANCER ASSOCIATION
Indexed
SCIE; SCOPUS; KCI WOS
Abstract
The vast majority of patients with metastatic prostate cancer present with bone metastases and high prostate specific antigen (PSA) level. Rarely, prostate cancer can develop in patients with normal PSA level. Here, we report a patient who presented with a periureteral tumor of unknown primary site that was confirmed as prostate adenocarcinoma after three years with using specific immunohistochemical examination. A 64-year old man was admitted to our hospital with left flank pain associated with masses on the left pelvic cavity with left hydronephrosis. All tumor markers including CEA, CA19-9, and PSA were within the normal range. After an exploratory mass excision and left nephrectomy, the pelvic mass was diagnosed as poorly differentiated carcinoma without specific positive immunohistochemical markers. At that time, we treated him as having a cancer of unknown primary site. After approximately three years later, he revisited the hospital with a complaint of right shoulder pain. A right scapular mass was newly detected with a high serum PSA level (101.7 ng/ml). Tissues from the scapular mass and prostate revealed prostate cancer with positive immunoreactivity for P504S, a new prostate cancer-specific gene. The histological findings were the same as the previous pelvic mass; however, positive staining for PSA was observed only in the prostate mass. This case demonstrates a patient with prostate cancer and negative serological test and tissue staining that turned out to be positive during progression. We suggest the usefulness of newly developed immunohistochemical markers such as P504S to determine the specific primary site of metastatic poorly differentiated adenocarcinoma in men.
DOI
10.4143/crt.2009.41.1.45
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의학전문대학원 > 의학과 > Journal papers
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