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69-year-old man has complaints of slow stream and nocturia. Prostate: 2+ enlarged. Left lobe is irregular at apex.
Chest: Negative. Bone scan and CT abd/pelvis: Negative.
PSA: slightly elevated. Alk phos: 126 (normal 69 - 241).
See Surgical Findings
Pelvic LN dissection. No gross extension beyond prostate, normal spermatic cords. Planned radical prostatectomy cancelled --frozen section positive for lymph node metastasis.
Biopsy: Adenocarcinoma of prostate, Gleason 7/10.
Pelvic lymph node dissection: Right obturator LN metastatic adenocarcinoma in 1/8 nodes; left obturator LN metastatic adenocarcinoma in 3/9 nodes.
Hormone : Began Lupron injections