Leukocytoclastic Vasculitis as an Initial Indicator of Prostate Cancer: A Case Report.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Maria-Alexandra Barbu, Miruna Ghigeanu, Razvan Andrei, Camelia G Badea
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引用次数: 0

Abstract

BACKGROUND One percent of paraneoplastic syndromes described in the literature present as cutaneous manifestations such as vasculitis, which may reveal potential initial diagnoses. Leukocytoclastic vasculitis is a subtype of small-vessel vasculitis. It affects the skin and internal organs, and diagnosis relies solely on histopathological examination. The literature on leukocytoclastic vasculitis linked with malignancies is scarce. CASE REPORT We present the case of a 60-year-old man with multiple cardiovascular comorbidities, presenting with dysuria and elevated prostate-specific antigen (PSA) levels. Further investigations led to diagnosis of metastatic prostate adenocarcinoma. Concurrently, he developed non-specific cutaneous lesions. He underwent hormonal therapy and radiotherapy. During initial treatment, the lesions rapidly progressed to necrotic ulcers; therefore, hormonal therapy was withheld. Extensive investigations ruled out potential infectious or rheumatological causes of the lesions, and histopathological analysis was consistent with cutaneous leukocytoclastic vasculitis. The patient underwent systemic corticoid treatment while continuing radiotherapy. Following completion of radiation therapy and a corticosteroid course, the patient showed good clinical response, with decreased PSA level, resolution of urological symptoms, and clinical improvement of the lesions. He was cleared for hormonal treatment continuation. CONCLUSIONS Given the temporal relationship between the onset of vasculitis, its exacerbation during first days of cancer treatment initiation and the rapid resolution following radiotherapy, a paraneoplastic etiology for leukocytoclastic vasculitis can be considered in this case. While the literature on leukocytoclastic vasculitis associated with malignancies is limited, clinicians must maintain vigilance to ensure timely and accurate diagnosis.

白细胞胞浆细胞性血管炎是前列腺癌的最初征兆:病例报告
背景文献中描述的副肿瘤综合征中有百分之一表现为皮肤表现,如血管炎,这可能揭示了潜在的初步诊断。白细胞凝集性血管炎是小血管炎的一种亚型。它影响皮肤和内脏器官,诊断完全依赖于组织病理学检查。有关白细胞凝集性血管炎与恶性肿瘤相关的文献很少。病例报告 我们报告的病例是一名 60 岁男性,患有多种心血管并发症,出现排尿困难和前列腺特异性抗原(PSA)水平升高。进一步检查后确诊为转移性前列腺腺癌。同时,他还出现了非特异性皮肤病变。他接受了激素治疗和放射治疗。在最初的治疗过程中,皮损迅速发展为坏死性溃疡;因此,激素治疗被暂停。广泛的检查排除了皮损的潜在感染或风湿病原因,组织病理分析与皮肤白细胞破损性血管炎一致。患者接受了全身皮质类固醇治疗,同时继续接受放疗。在完成放疗和皮质类固醇治疗后,患者表现出良好的临床反应,PSA水平下降,泌尿系统症状缓解,病变临床改善。他获准继续接受激素治疗。结论 鉴于该病例中血管炎的发病、在开始接受癌症治疗的头几天病情加重以及放疗后病情迅速缓解之间的时间关系,可以考虑白细胞凝集性血管炎的副肿瘤病因。虽然与恶性肿瘤相关的白细胞凝集性血管炎的文献有限,但临床医生必须保持警惕,以确保及时、准确的诊断。
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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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