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Case #4

Click an information source below to view the case history.

Expand Physical Exam

06/06/XX

54-year-old man had trouble urinating for several months. Rectal: Enlarged, hard asymmetrical prostate, with nodule present in right lobe.

Expand X-Rays & Scans

07/01/XX

Pelvic CT scan: Negative for mets.

07/06/XX

Bone scan: No mets; arthritis only.

Expand Scopes

See surgical findings.

Expand Laboratory

06/06/XX

PSA 58.0

Expand Surgical Findings

06/06/XX

Cystourethroscopy and TURP: Tumor extended from the anterior lobe of the prostate and extended to the bladder neck and bladder wall; also extended all the way out to the verumontanum. There is concern for capsular involvement. Radical retropubic prostatectomy not advised due to severe respiratory disease.

Expand Pathological Reports

06/06/XX

Gross: Biopsies of bladder neck, bladder wall, and prostate. Micro: Extensive poorly diff adenoca, Gleason 4+4 = 8 of the prostate gland; also involves the bladder neck and the bladder wall.

Expand Treatment

06/06/XX

TURP.

07/20/XX

Hormone: Lupron injection

09/01/XX

Radiation: Beam radiation to prostate and seminal vesicles 4500 cGy 5 field IMRT 6MV, boost to prostate 3060 cGy 5 field IMRT 6MV