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Case #2

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Expand Physical Exam

03/08/XX

70-year-old man with history of benign prostatic hypertrophy (BPH) and urinary retention, has recent history of soreness in groin, low back pain and weight loss. DRE: Normal rectal tone. Enlarged nodular prostate with minimal induration.

Expand X-Rays & Scans

03/20/XX

Bone scan: Generalized whole body skeletal metastases. Hip knee and ankle: Extensive bone mets in entire pelvis, right and left proximal femurs. Chest: Patchy areas of asbestos-like scarring, consistent with prior films.

Expand Laboratory

03/08/XX

PSA level 120 (0-4.0 ng/ml)

Expand Scopes

03/10/XX

Cystoscopy: Bladder was without masses or stones.

Expand Surgical Findings

03/10/XX

TURP: Resection included significant tissue from the anterior lobe of the prostate.

Expand Pathological Reports

03/10/XX

TURP: Prostate chips - Adenocarcinoma, prostate. Moderately to poorly differentiated, Gleason's score 5+5=10. Carcinoma involves every fragment.

05/15/XX

Orchiectomy: R and L testis: no tumor identified.

Expand Treatment

03/10/XX

Surgery: Transurethral resection of prostate (TURP).

03/25/XX

Hormone: Casodex

05/15/XX

Hormone: Bilateral simple orchiectomy