A 69-year-old patient presented with exoborrheic lesions located in the interpectoral area and bulloma in the right frontal region. She consulted due to melanoma in November 2005.
The patient had a history of recurrent facial deformities that had been excised five years ago.
HBP with Vals 160 and Sutril.
No known allergies.
Ex-smoker 3 years old.
No hematuria.
No cramps.
No UTIs.
She was referred to our clinic at 16 days of age in December 2005 for PSA elevation once the FNAC of the adenocarcinoma area was reported (who, after investigation, showed PSA + in immunohistochemistry), with no voiding symptoms and voiding.
On examination, a subcutaneous tumor adhered to deep tissue was observed in the right frontal region. Rectal Tact: prostate grade II-III, hard pink, clearly spectacle of prostate adenocarcinoma.
The evidence was not indicated for prostate biopsy and if it was performed on one side FNA of lesion: Positive for malignant cells, suggestive of adenocarcinoma, later biopsy of frontal region tumor that does not detect defective signs of colitis.
Laboratory tests revealed normal blood count.
Normal biochemistry.
Beta-HCG: 1.2 IU/L (0-5); Alfa-FP: 1.7 ng/L (0-15); PSA: 1139 ng/ml.
Normal rectum.
CT scan showed frontal and cranial metastasis, rib, right sacroiliac joint and multiple vertebral involvement.
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Screening bone scintigraphy with 99m-Tc-HDP shows multiple pathological foci of tracer uptake along the bone skeleton compatible with disseminated disease on the left costal bone right vertebral arch, dementia praise
Pelvic MRI showed a mass of more than 1 cm in the left ventricle. A large mass affected the left peripheral and primary occlusion of the seminal mesoprophylaxis ruled out the right angle in the left.
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With the diagnosis of prostate adenocarcinoma T4N1M1 treatment was established with complete hormonal blockade with Triptorelin 11.25 mg quarterly and Bicalutamide 50 1c/24 hours.
Treatment was initiated with Zoledronic Acid 4 mg administered intravenously over 15 minutes every 3 weeks and calcium supplements 500 mg 1 c/24 hours and 400 IU vitamin D.
