Misdiagnosis of One Patient with Prostate Cancer and Pulmonary Metastasis and a Literature Review

LIU Jun-ling; XIE Xiao-dong; ZHENG Zhen-dong; HAN Tao; LIU Yu-hui

doi:10.3969/j.issn.1002-3429.2016.12.015

Abstract：Objective To investigate diagnosed points and causes of misdiagnosis and missed diagnosis of prostate cancer. Methods Clinical data of I patient with prostatic carcinoma like as primary lung cancer was retrospectively analyzed, and related literature was reviewed. Results The patient was admitted for slightly abdominal distension and pain in left knee joint for 1 month, the right pulmonary occupying lesion for 1 week and both lower limbs numbness for 3 d. Abdominal CT ex-amination showed pelvic lymph node hyperplasia, and chest CT showed space-occupying lesions in hilum of right lung and right upper lobe, and then lung cancer multiple pulmonary and renal metastatic tumors considered in other hospital. Percuta-neous pulmonary puncture biopsy was performed by CT guidance after admission in our hospital, and pathological findings sug-gested metastatic adenocarcinoma from the prostate. Thoracolumbar spine MRI showed multiple metastatic tumors of vertebral body. Ultrasonography examination showed benign prostatic hyperplasia, and serum prostate specific antigen ( PSA) was more than 300 ng/ml. Prostate cancer Ⅳperiod (cTxN0M1) multiple pulmonary and renal metastatic tumors confirmed, and then Bicalutamide combined with Goserelin was given. Soft paralysis of both lower extremities occurred in course of the disease, and the patient was given surgery treatment. PSA level was normal, but motor function of both lower limbs was not recovered totally for the patient in postoperative 10 months of follow-up. Conclusion Prostate cancer is prone to bone and lung metasta-sis, so clinicians should consider prostate cancer metastasis for elder patients with lung and bone tumors, and related examina-tions should be performed as early as possible in order to avoid misdiagnosis and missed diagnosis.