- Burnt-out Metastatic Prostate Cancer.
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Dong Suk Shin, Dong Hoe Koo, Suhyeon Yoo, Deok Yun Ju, Cheol Min Jang, Kwan Joong Joo, Hyun Chul Shin, Seoung Wan Chae
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Yeungnam Univ J Med. 2013;30(2):116-119. Published online December 31, 2013
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DOI: https://doi.org/10.12701/yujm.2013.30.2.116
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- A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.
- 2 cases of male urethral diverticulum combined with stone.
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Hyun Chul Shin, Young Soo Kim, Tong Choon Park
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Yeungnam Univ J Med. 1992;9(2):416-421. Published online December 31, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.2.416
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Abstract
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- Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection (prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricture, impacted stone, Cunningham clamp or condom catheter) and trauma (instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors, 1) a ureteral or bladder calculus that is lodged in the urethra 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum combined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.
- A case of giant lymph node hyperplasia in the spermatic cord.
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Hyun Chul Shin, Young Soo Kim, Tong Choon Park, Young Ran Shim
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Yeungnam Univ J Med. 1992;9(1):175-180. Published online June 30, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.1.175
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Abstract
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- Giant lymph node hyperplasia (Castleman's disease) is a rare disease, which represents a peculiar form of lymph node hyperplasia. Generally, it has been considered as benign and localized disease but recently, revealed malignant transformation in some cases of multicentric form. It usually occurs on the mediastinum and occasionally neck, lung, axilla, mesentery, broad ligament, retroperitoneum or soft tissue of extremities. Histopathologically, it is divided into hyaline vascular or plasma cell type and the former is characterized with prominent vascular proliferation and hyalinization in the central portion and tight concentric layering of lymphocytes at the periphery of the follicles (mantle zone) and the latter is characterized by a diffuse plasma cell proliferation in the interfollicular area. From the point of view of clinical presentation, it has been divided into solitary form, which presents as a localized mass located most commonly in the mediastinum, and multicentric form, which occurs multiple location and has systemic manifestation and transformation into malignancy. Herein we report a case of Giant lymph node hyperplasia occurring in the left spermatic cord in a 58-year old male with brief review of literatures.
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