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Biomedical subjects

G Muzzonigro

Publications and source records attributed to G Muzzonigro.

At least 19 recordsLinked to original sources
PubMed2007

Correlation between urodynamics and perineal ultrasound in female patients with urinary incontinence.

AIMS: We performed urodynamics and perineal ultrasound in female patients with urinary incontinence to assess morphology and function of the bladder base-urethra complex and of the detrusor muscle, and to find the correlation between these investigations in the diagnosis of (a) bladder neck and urethral hypermobility and (b) detrusor overactivity; we wanted to compare the tolerabililty of the urodynamic investigation and of the perineal ultrasound. METHODS: We considered 66 female patients referred to our outpatient clinic for urinary incontinence; we also studied 14 healthy control patients. After accurate case-history collection and physical examination, urodynamic investigation and perineal ultrasound were performed, with recording of parameters specific to both investigations. The statistical analysis was performed by ANOVA, Bonferroni post hoc test, and Spearman correlation test. The tolerability index between the diagnostic investigations performed was assessed by a 3-point scale suggested by the patient. RESULTS: In patients with stress incontinence the posterior urethro-vesical angle, the angle of urethral inclination, and the proximal pubo-urethral distance are significantly different under stress compared to the resting phase; in patients with urge incontinence, the detrusor wall is thicker and is accompanied by an increase in opening detrusor pressure and detrusor pressure at maximum flow; it is also accompanied by detrusor overactivity with increased urethral functional length. Increased urethral functional length is suggested on axial US images by alteration of its normal characteristic target-like appearance with four concentric rings of different echogenicity. In all cases the tolerability of perineal ultrasound has been higher than that of urodynamics. CONCLUSIONS: There is a good correlation between urodynamic and perineal ultrasound in the diagnosis of bladder neck and urethral hypermobility; perineal ultrasound can also be useful in the diagnosis of urge incontinence. Functional compressive urethral obstruction can be diagnosed on the basis of the ultrasound aspect of the urethral sphincter.

Adult↗
PubMed2005

Prognostic role of Fuhrman grade and vascular endothelial growth factor in pT1a clear cell carcinoma in partial nephrectomy specimens.

PURPOSE: Conventional renal cell carcinoma (RCC) is characterized by rich neovascularization and shows a fine vascular network around tumor cells. Nephron sparing surgery has been established as a method of choice or necessity for localized tumors. We investigated the importance of microvessel density (MVD), vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (Flk-1) immunohistochemical expression in a large series of small conventional clear cell renal carcinomas treated with partial nephrectomy and assessed the prognostic value of their expression in terms of patients survival at long-term followup. MATERIALS AND METHODS: A total of 48 patients with a mean age +/- SD of 58.2 +/- 9.5 years who had conventional single RCC were considered. Median tumor diameter was 2.92 +/- 0.82 cm (range 1.3 to 5). Disease was grades 1 to 4 in 15, 29, 2 and 2 patients, respectively. Median followup was 92.9 months (range 17 to 186). RESULTS: Four patients (3.9%) had died of metastatic renal cancer at a median followup of 23.5 months, of whom 1 had a grade 2, 1 had a grade 3 and 2 had grade 4 RCC. Patients with MVD expression higher than the median (44.4 vessels per mm) did not show a significant difference in survival compared to patients with MVD expression lower than the median. Patients with VEGF expression higher than 25% in the histological specimen showed worse survival than patients with VEGF expression lower than 25%. Different Flk-1 expression did not determine a significant difference in survival. On univariate analysis of patient survival in relation to the different considered factors Fuhrman grading was the most important factor for survival. CONCLUSIONS: Our study shows that recurrence and death are possible even in patients with small renal tumors. MVD, VEGF and Flk-1 expression do not depend on tumor size in pT1a RCC. Therefore, to date Fuhrman grading appears to be the only factor predictive of survival even in small RCC. Thus, Fuhrman grading is predictive of mortality. While VEGF is not predictive of survival as a single parameter, based on its percent of expression (lower or higher than 25%) it can determine 2 groups that are different from the prognostic point of view.

Adenocarcinoma, Clear Cell↗
PubMed2004

Cardiovascular effects of sildenafil in hypertensive men with erectile dysfunction and different alleles of the type 5 cGMP-specific phosphodiesterase (PDE5).

Erectile dysfunction (ED) is frequent in patients with essential hypertension (EH); a likely common pathogenetic pathway could be a reduced ability of arteriolar vascular smooth muscle (VSM) to relax. Increasing intracellular levels of cGMP reduce the contractile status of VSM; on the contrary, type 5 cGMP-specific phosphodiesterase (PDE5, codified by PDE5A gene) regulates cGMP levels through its clearance. The PDE5A gene represents a good candidate for the intermediate phenotype EH/ED: genetic variants of the PDE5A may predispose to EH and ED and could affect the local and systemic response to sildenafil administration. Thus, a functionally relevant portion of PDE5 5'-flanking promoter region was analyzed by PCR and direct sequencing in patients with EH and idiopathic ED. The sequences obtained showed a T/G polymorphism at position -1142, near an AP1 regulatory element, that was not apparently associated with the intermediate phenotype. We also studied the relationship between this polymorphism and the effects of oral sildenafil on blood pressure (BP) and heart rate (HR) in men with ED. Sildenafil caused a significant decrease of BP, but had no effects on HR; statistical analysis showed no differences in BP and HR variations among PDE5A genotypes. In conclusion, our data showed no correlations of a novel polymorphism of the PDE5A promoter gene with the intermediate phenotype EH/ED and the BP and HR response to sildenafil administration. Further studies are necessary to define the role of this polymorphism and to study the genetic predisposition for EH with ED.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2004

Percutaneous therapy of varicocele: effects on semen parameters in young adults.

BACKGROUND: In spite of many years of debate, the impact of varicocele on male infertility is still controversial since its pathogenetic role on the impairment of semen quality has never been fully demonstrated. METHODS: In the present work, a series of 426 young adult males undergoing percutaneous treatment of varicocele were studied and semen parameters were evaluated at baseline and 12 months of follow-up. RESULTS: A significant increase in sperm cell concentration and a decrease in immotile spermatozoa were found after varicocele repair, but we failed to detect any significant positive change in progressive motility as well in sperm morphology after treatment. Similar results were also obtained when semen parameters were correlated with the degree of varicocele. CONCLUSION: Since a spontaneous improvement in semen quality has been mathematically established as a model of regression toward the mean, we conclude that the correction of varicocele in young adults is not a major indication when semen alteration is the only clinical problem.

Adult↗
PubMed2003

Massive spontaneous perirenal hematoma and accelerated hypertension in a patient with polyarteritis nodosa.

A 43-year-old Albanian man is presented who underwent nephrectomy for a huge right spontaneous perirenal hematoma. The diagnosis of polyarteritis nodosa as the etiology of the hematoma has been made only by histological examination, because of the quick and unforeseeable onset of this complication and the nonspecificity of symptoms. We hypothesize a relationship between reactivation of polyarteritis nodosa and treatment with rifampicin and isoniazid.

Adult↗
PubMed2001

Diagnostic accuracy of percent free prostate-specific antigen in prostatic pathology and its usefulness in monitoring prostatic cancer patients.

INTRODUCTION: The aim of our study was to evaluate the clinical usefulness of percent free prostate-specific antigen (PSA) [ratio of free PSA (fPSA) to total PSA (tPSA); f/tPSA] in prostatic pathology and its usefulness in monitoring prostatic cancer patients. PATIENTS AND METHODS: Our prospective study was carried out on 470 consecutive male patients referred to our outpatient urological clinic for observation. We looked for relationships between tPSA, fPSA and percent free PSA and the patient's age, prostatic volume and histologic diagnosis as assessed by prostatic biopsies or surgical specimens (benign prostatic hypertrophy, carcinoma, hypertrophy with inflammation). In all cases, we calculated the specificity, sensitivity and diagnostic accuracy of percent free PSA in the diagnosis of prostatic diseases, using cutoff values ranging from 14 to 20%. In prostatic cancer patients, we considered the relationships between the various PSA molecular forms and staging, grading and follow-up values. We also evaluated the effects of hormonosuppressive therapy on the serum markers and noted for which tPSA value percent free PSA possessed the greatest diagnostic accuracy. RESULTS: While tPSA and fPSA values appeared to be correlated with patient age and prostatic volume, percent free PSA did not show a relationship with these parameters. The specificity, sensitivity and overall diagnostic accuracy were better assuming a 16% cutoff value for percent free PSA than with other cutoff values. Prostatic inflammation associated with benign hypertrophy can cause false positives in both tPSA and f/tPSA measurements, since 60% of these patients have an f/tPSA ratio below 16%. In diagnosing carcinoma, the diagnostic accuracy of percent free PSA is 100% when tPSA is between 2.5 and 4.0 ng/ml. Percent free PSA is not linked with staging in prostatic cancer, but it does appear to be related to the Gleason score. In patients receiving hormonosuppressive treatment, f/tPSA decreased significantly, and more so in patients with a higher Gleason score. In patients with disease in rapid progression, percent free PSA was lower than in patients in a stable condition. CONCLUSIONS: Based on our experience, 16% as the f/tPSA cutoff value for discriminating between benign and malignant pathologies is the best possible choice, as it provides the highest overall values of sensitivity, specificity and diagnostic accuracy (80, 61.5 and 84.5%, respectively) in the diagnosis of prostatic cancer. We believe that f/tPSA is not a definitive test for diagnosing prostatic cancer. Our observations on the behavior of percent free PSA in relation to prostatic carcinoma grading and staging and in the follow-up of carcinoma patients are interesting; however, further studies are needed to define the appropriate role of f/tPSA in patients with an established diagnosis of prostatic carcinoma and in the follow-up of patients with prostatic cancer.

Adult↗
PubMed2001

Pressure-flow studies in men with benign prostatic hypertrophy before and after treatment with transurethral needle ablation.

BACKGROUND/AIMS: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the effects on erectile and ejaculatory function. MATERIALS AND METHODS: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 +/- 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. RESULTS: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. CONCLUSIONS: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of <60 cm H(2)O, with a baseline detrusor pressure at maximum flow of <60 cm H(2)O, with a pretreatment residual volume of <100 ml and with a QOL score of <5.

Aged↗
PubMed2000

Prostate tissue and serum markers.

Serum prostate specific antigen (PSA) is elevated beyond the arbitrary cut-off point of 4.0 ng/ml in the majority of patients with prostate cancer (PCa). It may also be greater than 4.0 ng/ml in some benign conditions, including benign prostatic hyperplasia (BPH). Therefore, serum PSA lacks high sensitivity and specificity for PCa. This problem has been partially overcome by calculating several PSA-related indices (such as PSA density, PSA velocity, percent free PSA) and/or evaluating other serum markers (such as human glandular kallikreins and prostate specific membrane antigen). Atypical small acinar proliferation (ASAP) often represents the underdiagnosis of cancer in biopsy material; patients with cancer on the repeat biopsy usually have an elevated serum PSA. Whether the determination of serum PSA can be of help in the identification of patients with isolated prostatic intraepithelial neoplasia (PIN), i.e., long before PCa develops, is still being debated

Humans↗
PubMed2000

[Fragments of prostatic biopsy: characteristics, dimensions, and number].

Prostate needle biopsy can give important clinical information on tumor extension and grading, useful prognostic parameters for the therapeutic choice and prognostic definition. Currently about the 25% of positive biopsies for carcinoma contain only small foci of cancer that makes histopathological evaluation often the difficult and less reliable. We reviewed the literature about different methods to perform needle biopsies and methods to improve histologic yield of prostatic biopsies in order to obtain more histopathological information on the specimens to improve diagnostic accuracy on core biopsy. We report our initial experience using the preembedding methods proposed by Rogatsch. The best method to perform a prostate biopsy includes the use of using 18-gauges needles, single specimen identification and subsequent orientation of every bioptic fragment by inking its proximal end. We performed the preembedding technique of the fragments, proposed by Rogatsch et al., stretching the fragment between two nylon meshes enclosed in a tissue cassette in formalin. The full length of the biopsy is within the section plane. This technique partially modified in our preliminary experience with the employment of two sponges containing 10% buffered formalin placed in a tissue cassette (2.8 x 3.3 cm). This "sandwich" technique has furnished evident advantages for the pathologist, optimizing the visible area for section plane in comparison to that obtainable from free floating core biopsies. In conclusion, routinely application of the preembedding prostatic core biopsies could improve the accuracy of the histopathological examination and therefore provide more reliable data on tumor extension and grade.

Biopsy, Needle↗
PubMed2000

[Intraprostatic spread of prostatic carcinoma: stereographic representation based on ultrasonography and biopsy findings].

The aim of this study is to identify and evaluate a scheme of graphic representation of the prostate, that allows the reconstruction of cancer diffusion based on ultrasound findings and on histological biopsy findings. A graphical representation of the prostate using transversal and longitudinal sections is represented by the US-operator, who write severy single performed biopsies (site, directions, and angle) and draws the US relieves. Biopsy specimens are separately prepared on a paper-support and marked at one extremity with china ink. The histopathological examination on every single specimen allows to identify the tumor extent, Gleason grading and the percentage occupied by the neoplasia. Were performed 50 transrectal echo-guided mapping biopsies. Comparing biopsy results with the pathological analysis on 13 whole-mount radical prostatectomy: pathological stage was predicted in 6 of 7 cases, Gleason grading was predicted in 85% of cases. In 5 cases in which the core biopsy histological analysis showed only atypical glands suspicious for cancer it has been possible to repeat new biopsies in the same site of the gland. Tumor was this time diagnosed in 3 of 5 cases (60%). The proposed approach can be useful to reduce variables linked to operator, technique, and single clinical situation, but it needs an employment on a higher number of cases and a verification on more surgical specimens. The scheme proposed has been of easy complication and immediate interpretation by clinicians and pathologists.

Aged↗
PubMed2000

[Ultrasound-guided cryosurgery of the prostate: short- and long-term experience].

We have assessed 24 patients consecutively treated with cryosurgery and chosen according to the guidelines of the European Study Group of Urologic Cryosurgeons. Of the 24 patients (average age about 70, range 61-79), all were not considered candidates for radical prostatectomy, 9 (37%) were clinical stage cT2 N0M0, 15 (63%) cT3 N0M0 who had not received any prior treatment, except 1 patient (61 years old) who was treated with TCT and successive recurrence of the disease (cT2). Of the 24 chosen patients, 13 (55%) were over the age of 71, 11 (45%) had important factors of co-morbidity and an elevated risk of surgery (ASA 3). The average PSA was of 19.3 ng/ml (range 2.2-61). Gleason score was 2-5 in 9 cases, 6-7 in 14 and 8-10 in 1 case. In the follow-up, we evaluated serum PSA every 3 months and transrectal ultrasound and the echoguided prostatic biopsies at 6, 12 and 24 months. Post-operative complications included: ecchymosis and edema of external genitals (16/24), fever > 38 degrees C (1/24), sloughing syndrome (6/24), urinary tract infections (10/24) acute urine retention (1/24). In 2 cases, 6 months after treatment, a transrectal resection was carried out. After a follow-up at 6 months, the PSA was 0.4 ng/ml (range 0.1-0.9), in 1 case. In positive core biopsy out of 6 showed neoplastic cells with fibrous tissue; the patient had a PSA of 0.58 ng/ml. At 12 months there were 11 assessable patients. The average PSA was 0.3 ng/ml (range 0.1-0.9). At 24 months there were 4 assessable patients, 1 of 4 showed serum PSA level of 4 ng/ml and cancer in apical biopsy. Erectile dysfunction was assessed on 8 patients affective before surgery: 1 referred to sufficient erections at penetration (1/8, 12.5%). After removal of the catheter, 4 of the 20 patients suffered stress and urge incontinence with the use of 1 pad a day. In 1 case, 18 months from surgery, slight stress incontinence was found (1 pad/day). Cryoablation is an efficient method and is given to slight post-operative morbidity and no intra-operative mortality, also in patients with high risk for open surgery. Indications may be found in patients with the following conditions: older than 72 years, severe co-morbidity and high risk for surgery, neoplasia at high risk of progression, and disease recurrence after radiotherapy. Our case history is at the moment encouraging and a larger number of cases as well as longer follow-up are needed.

Aged↗
PubMed2000

[Role of transrectal ultrasonography in the follow-up of patients treated with prostatic cryosurgery].

Cryosurgery of prostate is a minimally invasive treatment for localized cancer. Imaging techniques (transrectal ultrasound (TRUS) or magnetic resonance) have been proposed to evaluate tumor persistence/recurrence after cryosurgical treatment other than serum PSA and prostate biopsies. Actually, criteria to identify cancer after cryosurgical ablation are not well assessed. Aim of this study is to evaluate the clinical significance and role of TRUS in detecting tumor within the former prostate gland after cryoablation. We evaluated ultrasound (US) features and imaging, serum PSA and biopsies in 20 patients treated by cryosurgery at our Hospital with a mean follow-up of 18 months. Twenty patients (mean age 70 years, PSA 25.9 ng/ml, clinical stage: 10 T2 N0M0 and 10 T3 N0M0) were followed up for a mean of 16 months. Ultrasound findings (gland volume, capsule, hypoechoic area, post-voided urine volume, seminal vesicles) were correlated to PSA levels (every 3 months) and prostate biopsies (6, 12 and 24 months). All cases were evaluated by the same ultrasound scanner (Eidos, Hitachi-5-6.5 MHz) and by two operators. Prostate capsule was interrupted by hypo-hyperechoic areas in all cases. Transition zone was no more recognizable. Ultrasound findings showed in all cases hypoechoic areas, but US did not identified tumor recurrence in 2 patients. During follow-up, PSA below 0.5 ng/ml was recorded in 75% of cases. We detected tumor in 2 cases, respectively 12 and 18 months after cryosurgery: in the first case few residual cancer cells within fibrous tissue were found in 1 out of 6 biopsies at 6 months (PSA 0.58 ng/ml), in the second one, tumor with viable normal prostatic glands was found in one biopsy of the apex at 18 months (PSA 4.0 ng/ml). TRUS showed several anaechoic foci with necrotic tissue and coalescence of liquid areas in 2 patients (one developed acute urinary retention). Actually, serum PSA is the best marker in order to detect clinically significant tumor after cryosurgery. Hypoechoic areas and capsule interruptions observed by ultrasound imaging of prostate gland after cryosurgery are not correlated with tumor recurrence or tumor persistence. TRUS is only indicated for ultrasound-guided biopsies during follow-up and to confirm urologic complications.

Aged↗
PubMed1999

Nodular hyperplasia of the prostate. Quantitative evaluation of secretory cell changes after treatment with finasteride.

OBJECTIVE: To quantitatively evaluate the changes in the secretory cells in nodular hyperplasia of the prostate after treatment with finasteride. STUDY DESIGN: Secretory cell nuclear and nucleolar measurements were performed with an image analyzer in hematoxylin-and-eosin-stained sections of 20 untreated and 20 finasteride-treated cases of nodular hyperplasia. An immunoperoxidase method was used to stain the secretory cells with a monoclonal antibody-directed, anti-prostate specific antigen (PSA). The size of prostates was determined by transrectal ultrasound. For both groups the serum PSA values were determined. RESULTS: After six months of treatment with finasteride, the prostates shrank by approximately 20% with the therapeutic regimen (as determined by transrectal ultrasound), whereas the serum PSA values decreased by 30% (before therapy, < 4.00 ng/mL). The secretory cells appeared smaller than those from the untreated group of patients, and the cytoplasm staining of the PSA marker was slightly diminished. Karyometric analyses showed that the nuclear and nucleolar size were smaller in comparison with the controls. In particular, the mean nuclear and nucleolar area in the treated group were, respectively, 34.12 and 1.424 micron 2, whereas in the untreated group the values were 40.46 and 2.261. CONCLUSION: Reduced androgen stimulation after treatment with finasteride induces involution of secretory cells. This may be responsible for the decrease in the serum PSA level and may contribute to the reduction in prostate size.

Aged↗
PubMed1999

[Urinary NMP22 as a new marker in patients with transitional cell carcinoma].

To evaluate urinary NMP22 dosage as a marker of urothelial tumours, we have selected a group of 90 patients (85 males and 5 females, mean age 66 years) with clinical suspicion of transitional cell carcinoma (TCC), with microscopic or macroscopic hematuria, flank pain, urographic abnormalities and dysuria. All the patients have been evaluated by urinary cytology, renal and bladder ultrasound, cystoscopy. When a bladder tumour has been detected, bladder biopsies and, when required, I.V.P., CT or retrograde pyelography have been performed. A urine sample has been collected between midnight and noon; all samples from patients who were undergoing invasive procedures such as cystoscopy, were collected before or at least 5 days after the procedure. The test has been performed according to ELISA NMP22 (Matritech) technique; the test is specific for the nuclear matrix protein/nuclear mitotic apparatus protein expressed by cancer cells. When performing the test, 30 patients presented macroscopic hematuria. 22 patients resulted to have benign urinary tract conditions, 65 patients had TCC and 3 patients had a final evaluation suspicious for TCC. The NMP22 values were respectively 7.1 +/- 4.7 U/ml, 21.9 +/- 21.0 U/ml and 16 +/- 8.0 U/ml. From our study the sensitivity of the test is 67% (with a threshold value of 10 U/ml) and 55% (with a threshold value of 20 U/ml), while the urinary cytology resulted to have a sensitivity of 26% (p < 0.05). The sensitivity of the test in relation to staging was as follow: Tis 66% with a mean NMP22 value of 23.3 U/ml, Ta 26% with a mean NMP22 value of 13.2 U/ml, T1 100% with a mean NMP22 value of 40 U/ml, T2 73% with a mean NMP22 value of 36.4 U/ml. The specificity of the test was 100% with a threshold value of 20 U/ml. When considering a threshold value of 10 U/ml, the NMP22 test has a sensitivity higher than cytology, especially in low stage TCC. Macroscopic hematuria does not affect its sensitivity; the diagnostic efficacy of the test is not increased by the association of urinary cytology. It has an important role in the diagnosis of residual disease after TURB and in the follow-up evaluation of bladder cancer patients, since its dosage is not influenced by inflammatory conditions of the mucosa. We believe therefore that NMP22 is useful in clinical practice.

Aged↗
PubMed1998

[Transurethral needle ablation (TUNA) in benign prostatic hypertrophy: 2-year follow-up].

In this study we have evaluated the effectiveness, safety and tolerability of TUNA in the long term follow-up. We have evaluated 24 patients, aged between 66 and 81 years (mean age 73, 4 yrs) with a mean prostatic volume of 57 ml (range 33-140 mls). Before treatment, urodynamic investigation (max flow rate), residual volume, PSA, IPSS and quality of life tests have been performed in all patients. After treatment, all the patient have been evaluated at 6, 12 and 24 months by the same parameters. Based on our experience, we can say that the results obtained after 24 months are similar to those observed 12 months after treatment, except a slight increase in IPSS and quality of life tests in patients older than 70 years, with a baseline maximal detrusorial pressure > 60 cm H2O, with a baseline residual urine > 100 cc and with a baseline quality of life = 5.

Aged↗
PubMed1997

Serum markers for monitoring of prostatic carcinoma.

BACKGROUND: Serum TPS (tissue polypeptide-specific antigen) has been observed to be characteristic of carcinoma proliferation, and increased levels of TPS seem to be closely related to tumor progression. In this study we wanted to evaluate the importance of the tumor-marker TPS in the diagnosis and follow-up of patients with prostatic carcinoma, and to compare it with prostate-specific antigen (PSA). METHODS: We considered 39 patients with clinically confined disease, who underwent neoadjuvant hormonal therapy and thereafter radical prostatectomy, and 45 patients who did not undergo surgery and underwent hormonal adjuvant therapy alone. PSA and TPS were measured at the time of diagnosis and at regular intervals in the follow-up; TPS was measured in a control group of patients as well. RESULTS: We were able to observe that, in untreated patients, PSA correlates with clinical stage, increasing with increasing tumor stage; a similar correlation was not observed when considering TPS. After androgen ablation we observed a decrease in PSA, but the serum values of TPS remained higher, suggesting that activity still exists inside the tumor. The evaluation of TPS appeared to be of particular interest in the follow-up after radical prostatectomy, especially in patients undergoing hormonal therapy; in fact, we were able to observe that relapse of the disease can be suspected early by the increase of TPS in hormonally treated patients. CONCLUSIONS: We assert that TPS can add useful information on the state of neoplastic illness, especially in patients following adjuvant androgen-suppressive hormonal therapy, after radical prostatectomy; serial measurements of this marker could be useful in the early diagnosis of a relapse.

Aged↗
PubMed1997

Skin metastases from prostate cancer associated with malignant melanoma.

A 66-year-old man, admitted to the hospital for prostatic carcinoma, presented with a nodular lesion located on the presternal region and a small nodule (0.5 cm in diameter) simulating a scalp sebaceous cyst located on the scalp. Moreover, an irregular darkbrown lesion was observed on the left side of the abdomen, and a brownish macula was also present on the presternal region. Histologic examination of the two nodular lesions revealed cutaneous metastases from prostatic carcinoma. The pigmented lesion, localized on the abdomen, proved to be a superficial spreading melanoma with a maximal depth of 1.36 mm. Histologic examination of the brownish lesion on the presternal region revealed nevus cell nests within the epidermis and in the dermis. We discuss the propensity of developing a secondary cancer in a patient with a primary malignancy.

Abdomen↗