Case Presentation HKC 1392

• A 78 y/o man

• obstructive symptoms

• Flank pain(_)

• Gross hematuria(-).

• LUTS(+)

Past history

•Open prostatectomy 1389/4/27 in Rasoul Akram Hosp.

Negative for malignancy

Physical examination

•Normal

•DRE:+ 1> /Firm/symmetric/without nodule

Lab data: 1389/8

• Cr:1.2

• PSA: 41

TRUS GUIDED BIOPSY:1389/9/27Adenocarsinom of prostate

Rt&Lt base : 4+4 , 4+3 (80% , 40%)

Rt&Lt upper- mid : 3+4 , 3+4 (90% , 70%)

Rt&Lt lower- mid : 4+4 , 4+4 (80% , 70%)

Rt apex : 4+3 ( 50%)

Lt apex: benign proststic tissue

PNI (+) Extra prostate (-)

Bone scan

•Multiple bone metastases

Medical therapy

• DIPHERELIN therapy since 1389/8 monthly

&

FLUTAMIDE since 1391/10

خرداد 91

91مهر 91دی مرداد 92

02468

101214

PSA 1testoColumn2

Thanks for Attention